Weekend Ramble: The Best Exercises If You Have Diabetes

Let's be honest... nobody enjoys exercise. Ok some people do but for the most part we diabetics are not the biggest fans. We're not young bucks anymore and may have a few extra pounds we're ashamed of on some level. If you're anything like me, I despise the whole gym scene. The smell alone tends to turn me around at the door. Now... we all KNOW that exercise will help us with our diabetes, so let's explore these low impact exercises that can actually be fun. My absolute favorite is walking. Carolyn and I have found many many trails of varying levels right in our own backyard. All you need to do is Google "Hiking trails near me" and let the internet find things that may very well surprise you! :-) 

Meanwhile... check out this neat list assembled by the good folks at WebMD.com

The Best Exercises If You Have Diabetes

Medically Reviewed by Michael Dansinger, MD on January 28, 2023

Fighting Diabetes? Do It Actively

Exercise is good for pretty much everyone. It’s especially important if you have diabetes. Workouts can do all kinds of things for you, like lower your blood sugar and blood pressure, boost your energy, and help you sleep better. If physical, high-impact exercises aren’t for you, there are plenty of other options.

Walk

It’s a simple way to get exercise and fresh air. It can lower your stress, too. A brisk stroll of 30 minutes to an hour 3 or 4 times a week is one way to hit your target. It’s easy to get started: Take Fido around the neighborhood or walk to the store instead of driving. Once you’ve made it a habit, it can be rewarding -- and motivating -- to track your steps and your progress.

Dance

This can be a fun way to get your exercise. Just shake your groove thing for 25 minutes, 3 days a week to help your heart, lower your blood sugar, ease stress levels, and burn calories. You don’t need a partner to get started, either. A chair can be good support if you need it.

Swim

This is one aerobic exercise that doesn’t strain your joints like other ones can. It also lets you work muscles in your upper and lower body at the same time. Hitting the water is also good for your heart. It can also lower cholesterol and help you burn serious calories. If a lifeguard is on duty, let them know you have diabetes.

Bike

Fighting diabetes can be as easy as riding a bicycle. Whether you use a stationary one or hit the road, 30 minutes a day 3 to 5 times a week can get your heart rate up, burn blood sugar, and help you lose weight without hurting your knees or other joints.

Climb Stairs

This can be a healthy and easy way to burn calories and get your heart and lungs working faster, especially if you have type 2 diabetes. Going up and down stairs for 3 minutes about an hour or two after a meal is a good way to burn off blood sugar. You can do it anywhere there’s a staircase, like when you need a break from work.

Strength Training

You do this with free weights or resistance bands. It can lower your blood sugar and help make your muscles and bones stronger. You get the most out of it if you do it twice a week -- in addition to your aerobic stuff.  You can do many of these exercises at home, like:

• Lifting canned goods or water bottles
• Push-ups
• Sit-ups
• Squats
• Lunges

Gardening

If the idea of traditional exercise isn’t for you, don’t worry. Time in your garden counts as both aerobic activity and strength training. It gets your blood going (since you’re walking, kneeling, and bending). It also builds muscles and helps your bones (since you’re digging, lifting, and raking). You’re also outside, where your stress levels can be lower.

Yoga

It’s worked for some 5,000 years as a low-impact exercise that can make you stronger and more flexible. Yoga can also help with balance. The motions, poses, and focus on breathing may also ease stress and help build muscle. That can keep your blood sugar levels more stable.

Tai Chi

This ancient Chinese art uses slow, controlled movements -- along with visualization and deep breathing -- to build strength. It can also help with mobility, balance, and flexibility. This gentle exercise can also lower your stress level. It may also help prevent nerve damage in your feet.

How Much Is Enough?

At least 30 minutes of aerobic activity 5 days a week can help the insulin in your body work better. We’re talking exercise that gets your heart and lungs going and kicks your blood flow into a higher gear. If you haven’t been active in a while, start with 5 to 10 minutes a day and build up over time.  Talk with your doctor before you start.

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Have a great week, everyone, and thank you for your support!

Blessed be… and happy cooking!

                                                            Chef Michael R

Weekend Ramble: Smoking and Diabetes

This topic is something very personal and literally a revelation to me, as I never knew there was a connection until August 28, 2024 when an article on WebMD caught my eye.

You see, I was a smoker for 26 years and quit on September 12, 1997. My primary reason for quitting was to make sure my boys grew up with their Dad alive. My own father died of his third heart attack at age 52. 

Smoking cessation became an integral part of my life for many years as a member of an online support group which eventually lead me to become a quit coach for almost a decade. In 2000 I wrote a book titled:

Don't Quit Smoking Alone!

Help & Encouragement from the Trenches of an Online Support Group

The book is available as a free read... click here :-)  Thousands have benefitted from perusing the topics covered in the book that focuses on the long-term maintenance of a successful quit. Have a look if you are a smoker or even former smoker.

Okay... let's get to this week's Ramble! If you are like me and were not aware of the connection between smoking and type 2  diabetes until now, my hope is that this article and my free book will help you move forward with your quit. 

Smoking and Diabetes

Medically Reviewed by Michael Dansinger, MD on June 15, 2024

Written by Keri Wiginton for WebMD.com

If you smoke, you’re more likely to get type 2 diabetes (T2D). In fact, your chances go up by 30%-40% when compared to someone who doesn’t smoke. If you already have diabetes, smoking can make it harder to control your blood sugar. It can also worsen other health problems.

One of the best things you can do for your health is to give up smoking. But it can be hard to stop on your own. That’s why it’s important to get support from friends, family, or online communities. You should also bring it up with your doctor. They have treatments that can help you quit.

How Can Smoking Lead to Diabetes?

Studies show nicotine, the active chemical in cigarettes, can raise your blood sugar. It can also hurt your body in many diabetes-related ways. You may get:

Insulin resistance: Nicotine makes it harder for your cells to respond to insulin. That’s the hormone that helps your body use the sugar in your blood. You’ll end up with higher glucose levels.

Inflammation: Chemicals in cigarettes hurt your cells. This can lead to inflammation. That’s when your body tries to heal itself. This kind of damage makes it harder for your body to use insulin the right way.

Belly fat: If you’re a heavy smoker, you may gain more weight around your midsection. Even if you’re not overweight, this central fat can raise your chances of insulin resistance and T2D.

Other health problems: Your “bad” LDL cholesterol can go up. At the same time, your “good” HDL cholesterol goes down. Smoking also raises your triglycerides. Those are a kind of fat found in your blood. High cholesterol and triglycerides have a link to T2D.

Smoking if You Have Diabetes

Nicotine makes it harder to control your blood sugar. If you use insulin, you may need to take more of it than someone who doesn’t smoke. Smoking paired with unmanaged diabetes can also speed up damage to your whole body. That’s because your big and little blood vessels get hurt.

Compared to someone with diabetes who doesn’t smoke, you’ll have an even greater chance of:

• Heart disease
• Eye problems
• Stroke
• Kidney failure 
• Nerve damage (neuropathy)
• Erectile dysfunction

 

Smoking and Sleep

Studies show smokers don’t get as much quality sleep. There’s a link between a lack of this restorative deep sleep and T2D. Part of the problem is that nicotine is a stimulant. That means it can keep you awake. But you may also have sleep problems as the chemicals leave your body at night. That’s called withdrawal.

On the flip side, you may find it hard to fall or stay asleep when you first quit smoking. If that happens to you, talk to your doctor. They can help you find ways to get a good night’s rest.

Does Smoking Cause Diabetes?

There’s a really strong connection between cigarette smoking and T2D. Many studies point to a cause-effect relationship. But some experts believe that it’s hard to say for sure that smoking alone causes diabetes. That’s because there are a lot of other things at play.

Some other drivers of T2D include:

• Stress
• Obesity
• A family history of diabetes
• A lack of exercise
• Health problems, like high blood pressure

 

Quitting Can Help

Your blood sugar may go up when you first stop smoking. This might happen because of post-quit weight gain. But experts aren’t sure if added pounds are totally to blame. Either way, you should stick with it. The longer you go without cigarettes, the better your insulin resistance will get.

If you don’t already have T2D, you may be more likely to get it when you first stop smoking. Your chances are highest the first 2 years after you quit. But if you abstain for 10-12 years, your chances are more like someone who’s never smoked.

If you’re finding it hard to quit, talk to your health care team. Your doctor may suggest a mix of treatment. That might include:

• Counseling
• Nicotine replacement therapy
• Mindfulness training for smoking cessation (MTS)
• Antidepressant (bupropion)
• Chantix, an oral medication that blocks nicotine receptors and eases symptoms of withdrawal
• Treatments for insomnia

You can also search for apps to help you quit, or you can call 800-Quit NOW (800-784-8669). Some online resources you can turn to include:

• Smokefree.gov
• American Cancer Society
• American Heart Association
• American Lung Association

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Have a great week, everyone, and thank you for your support!

Blessed be… and happy cooking!

Weekend Ramble: 6 Protein Mistakes You’re Making And How To Fix Them

Are you eating enough protein at breakfast? Most people aren’t.

By Anahad O’Connor - Writer for The Washington Post

Optimizing your protein intake can be tricky. It’s not just how much protein you eat that matters, but when you eat it, and the foods that you get it from. You may even have higher protein needs than you think depending on your overall health, your age, your activity levels and other factors.

Protein makes up our muscles, vital organs and skin cells, and it influences our metabolism, appetite and immune system. While our bodies can make some amino acids, which are the building blocks of protein, others we can only get from eating certain foods.

“We store carbohydrates, we store fat, but we don’t store protein — so we do need to eat it every day,” said Anne Kozil, a registered dietitian nutritionist in the food science and human nutrition department at Colorado State University. “If we consume too little protein for too long then we resort to consuming our muscle mass as a protein source, which you don’t want to do.”

We spoke to experts and analyzed studies to identify common protein pitfalls. Here are six of the biggest mistakes that people make when it comes to eating protein.

1: Not eating enough protein at breakfast

Think about your daily meals. Are you getting most of your protein at dinner? It’s common for people to eat relatively little protein at breakfast, slightly more protein at lunch, and then a high-protein meal for dinner, Kozil said.

Some studies estimate that Americans on average get about half their total daily protein intake at dinner alone.

That is in part because chicken, burgers, steak and other protein-rich foods are dinnertime staples. But many popular breakfast foods — such as bagels, cereals, breakfast bars, muffins and other pastries — tend to be relatively low in protein and high in refined carbohydrates.

That’s a problem because eating protein promotes satiety and helps to balance your blood sugar levels. If you skimp on protein at breakfast, then you’re more likely to experience hunger and cravings as the day goes on, making you more likely to reach for foods such as doughnuts, candy and potato chips, Kozil said.

Clinical trials in children and adults have found that when people are given high-protein breakfasts, they tend to feel fuller and are less prone to snacking throughout the day compared with people who are given breakfasts that are relatively low in protein.

Kozil said she sees this in her nutrition counseling practice all the time.

“People tell me ‘I just can’t stop snacking throughout the day,’ or ‘I’m craving sweets all day,’ ” she said. “And then we work on getting more protein at breakfast and that helps them a lot. It’s kind of miraculous. It gives people a sense of control. They don’t feel so out of control with their food choices anymore.”

Every person’s protein needs are different. But in general, you should aim to eat about 25 to 30 grams of protein at breakfast, Kozil said. If you’re far below that number, then increase your protein intake gradually. If you typically have a bagel for breakfast, then add a scrambled egg or two. If you eat muffins for breakfast, try switching to a cup of plain Greek yogurt with some nuts, seeds and berries on top.

Some other good options are cottage cheese, hard-boiled eggs or breakfast burritos with scrambled eggs, beans and cheese or avocado. You could also make a smoothie with a high-quality protein powder made from egg whites or whey, soy, or pea protein.

2: Eating peanut butter because it’s a ‘high protein’ food

You have probably heard that peanut butter has a lot of protein. Some popular peanut butter brands even boast about their protein content on their labels.

But in a report published in a top sports nutrition journal last year, exercise and sports nutrition scientists cautioned that peanut butter isn’t as high in protein as many people think. The report noted that peanut butter is an “energy dense” food: Ounce for ounce, it has a lot more dietary fat and calories compared with eggs, Greek yogurt, lean meats, chicken breast, beans, fish and other high-protein foods.

Peanut butter is certainly nutritious. It contains fiber, vitamins, minerals and heart-healthy unsaturated fats. But it contains at least twice as many grams of fat as protein. You should consider it a great source of fat, rather than a great source of protein, said Jose Antonio, an author of the report and a professor of health and human performance at Nova Southeastern University in Florida.

“If you read the nutrition label on any jar of peanut butter, you will see that it’s mostly fat,” said Antonio, who is also the chief executive of the International Society of Sports Nutrition. “The fat is good for you. But don’t fool yourself into thinking that you’re getting a lot of high-quality protein.”

Two tablespoons of creamy peanut butter — the amount in one serving, or one ounce — has about seven grams of protein, 16 grams of fat and 190 calories.

The authors of the report noted that people who use peanut butter to help them meet their protein needs should consider eating it in moderation because of its high calorie density. Otherwise, the authors warned, they may be setting themselves up for “unintentional weight gain.”

“Peanut butter is a healthy food, but calories still matter,” Antonio said. “If you want to gain weight, eat a bunch of peanut butter. It’s not a great source of protein.”

3: Not eating enough protein as an older adult

The National Academy of Medicine says that the amount of protein the average adult needs on a daily basis is 0.8 grams per kilogram of body weight, or the equivalent of 0.36 grams per pound of body weight. This translates to about 54 grams of daily protein for the average sedentary adult, around the equivalent of eating four ounces of grilled salmon, a 3-ounce grilled chicken breast and one hard-boiled egg.

But this amount — known as the recommended dietary allowance — is just the bare minimum that you need to avoid being malnourished. If you are an athlete or someone who exercises regularly, then you need to eat more protein — anywhere from 0.54 to 1 gram of protein per pound of body weight. You also need to eat more protein if you’re pregnant and in your second or third trimester (about 0.5 grams per pound of body weight).

But what many people don’t realize is that the protein requirements also depend on your age. As we get older, our muscle mass starts to dwindle, and this decline grows steeper after the age of 60. At the same time, our muscles become less responsive to protein as we get older, which makes it harder for our bodies to build and repair muscle tissue — a phenomenon known as anabolic resistance.

“As people age, we have less and less muscle mass, which makes it even more important to protect the muscle that we have,” said Katie Dodd, a registered dietitian nutritionist who runs a blog on nutrition for seniors called the Geriatric Dietitian. “We need muscle to do everything — even simple things like getting out of bed, walking down the stairs, and brushing our teeth.”

To counter this age-related muscle loss and anabolic resistance, it’s critical that older adults eat more than the recommended dietary allowance for protein, Dodd said. If you’ are 65 or older, you should aim to eat about 0.45 to 0.54 grams of protein per pound of body weight, she added. That is about 68 to 81 grams of protein a day for the average senior who weighs 150 pounds.

Research suggests that a substantial number of older adults do not consume adequate amounts of protein. One study of older adults in the United States, Canada, the United Kingdom and the Netherlands found that up to 30 percent did not meet the recommended dietary allowance of 0.36 grams of protein per pound of body weight.

4: Eating too much red and processed meats

Studies show that the top sources of protein in the American diet are chicken and red meat. Not far behind are milk and cheese, “cured” or processed meats, breads, rolls and other refined grains, and eggs.

But processed meats such as hot dogs, bacon, sausages and deli meats typically contain a lot of sodium, saturated fat and preservatives. Red meats such as beef, pork, lamb and veal are also high in saturated fat, which can increase LDL cholesterol, the kind associated with cardiovascular disease.

People who eat a lot of red and processed meats may be at higher risk of cancer, especially colorectal cancer, which has been rising among young adults. The American Institute for Cancer Research recommends eating no more than three portions of red meat weekly, which is equivalent to about 12 to 18 ounces of cooked meat. As for processed meats, the institute says that you should eat “little, if any.”

5: Not eating enough seafood

Seafood is one of the most nutritious high-protein foods you can eat. It is chock full of vitamins, minerals and omega-3 fatty acids, an essential nutrient that our bodies need but can’t produce. A 3.5-ounce serving of wild salmon has at least 22 grams of protein — the amount in nearly four eggs.

Health authorities recommend that you eat at least two servings of seafood each week. Yet 90 percent of adults in the U.S. fall short of this goal. If you’re in this group, then you could be missing out on some major health benefits.

Studies have found that eating seafood promotes brain and heart health and lowers your likelihood of early death. One meta-analysis of studies involving about 670,000 adults found that people who ate the most seafood were less likely to die prematurely from any cause. People who ate half a serving of fish per day, which is roughly two ounces, were 12 percent less likely to die early than those who ate little or no seafood.

The healthiest types of seafood include the following:

• Wild and farmed salmon
• Sardines, anchovies and Atlantic mackerel
• Rainbow trout
• Mussels
• Oysters

6: Not eating enough protein-rich plants

Another healthy source of protein you are probably overlooking is pulses, which include beans, peas and lentils. Pulses are brimming with not only protein, but also vitamins, minerals and fiber, a nutrient that promotes gut health, weight loss and that improves blood sugar and cholesterol levels.

Eating just a single cup of cooked lentils, black beans or pinto beans (or a combination of the three) would deliver 15 to 18 grams of protein and about 15 grams of fiber — more than half your daily fiber needs. Pulses are also among the most affordable high-protein foods in the world.

Yet the average American eats only a half cup of beans, peas or lentils each week — less than the one to three cups that health authorities recommend.

Many people tend to rely on red and processed meats for protein while forgetting that there are plenty of excellent plant sources of protein as well, Kozil said.

“I’m certainly not demonizing meat,” she added. “But I think beans are the best food in the entire world. They have a lot of fiber — which we don’t get enough of as a society — and they’re cheap, filling and full of protein.”

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Have a great week, everyone, and thank you for your support!

Blessed be… and happy cooking!

                                                            Chef Michael R

 

Weekend Ramble: How Do Tomatoes Affect Blood Sugar?

I have always known tomatoes to be a healthy food for just about everyone, but I wanted to know more specifically what kind of role these beauties play in the culinary world of a diabetic. In my research I came across this very informative and comprehensive article written by Registered Dietician Julia Zakrzewski on Signos.com.

How Do Tomatoes Affect Blood Sugar?

By Julia Zakrzewski, RD - Signos Health & Nutrition Writer

Science-based and reviewed

Published: September 7, 2022

Tomatoes are low in sugar and are packed with nutrients, making them a blood-sugar-friendly food. The bright red fruit is rich in lycopene, vitamin C, and potassium, which contribute to heart health and immune function.

All fresh tomatoes are low in sugars and because they fall low on the glycemic index, don’t usually have a significant impact on blood sugar levels. In fact, they are actually high in potassium and lycopene, which can help improve blood sugar. 

Keep reading to find out why these nutrients are important for your health, and how you can incorporate both fresh and canned tomatoes into your daily diet. 

Glycemic Index of Tomatoes

Fresh tomatoes are non-starchy vegetables that contain very few sugars and have a very low glycemic index (GI) score. It is estimated the GI is 15 for a 5oz tomato.

Do All Tomatoes Have the Same GI? 

There are hundreds of different varieties of tomatoes. The most popular ones you may recognize include: 

• Roma
• Heirloom
• Beefsteak
• Cherry 
• Grape 

Different types of tomatoes lend themselves to different preparations and uses. Because of their size, cherry and grape tomatoes are better suited for salads or an easy snack. Beefsteak and heirloom tomatoes are larger and a bit sturdier, so they can hold up on a sandwich. Roma tomatoes are naturally sweeter and are best used for canning or sauces. 

The USDA nutrient database lists similar carb content across the fresh tomato varieties and a similar GI scores across the board. So whether you are using your fresh tomatoes in a salad or turning them into a sauce, know your blood sugars should remain stable.

Will Fresh Tomatoes Raise Your Blood Sugar?

It is unlikely that fresh tomatoes will raise your blood sugar. A low GI score is an indicator that the food will slowly digest in your system and have a delayed effect on your blood sugar levels. 

But, tomatoes are not a significant source of fiber. They only offer approximately 1-2g of fiber per 100g serving. Pairing tomatoes with other vegetables, like dark leafy greens or avocado, can help increase your total fiber intake during your meals, which plays a key role in slowing down your glucose metabolism and absorption. 

Will Canned Tomatoes Impact Blood Sugar Levels? 

Canned tomatoes are still low in starch and will also have a low GI score. This means they should not impact your blood sugar levels, either. 

Sometimes canned tomatoes are prepared with herbs and spices. Commonly used canned tomato-based products, like sauces, have large amounts of added sugars. Sugars are used to balance the acidity of tomatoes, making them sweeter. If you see sugar on the ingredient list, put the can down and look for a sugar-free option. Added sugars are more likely to raise blood sugar levels.

Always try to buy unflavoured canned vegetables whenever possible. 

Glycemic Index of Tomato-Based Foods

Fresh tomatoes are a key ingredient for other foods. Here is a list of popular tomato-based products and their GI score:

• Tomato sauce (Marinara): 23
• Unsweetened tomato juice: 38
• Canned tomato soup: 38

Tomato paste and condiments, such as ketchup, do not have assigned GI scores. These items are usually referred to as miscellaneous sauces that are used to enhance the flavor of foods instead of being a full meal. 

An entire bottle of ketchup can have high sugar content (again, check your labels!). But if you monitor your portion sizes, you would only be consuming 3g of sugar per tablespoon. You can control how much sauce you add to your meals and monitor your sugar intake.  

When buying tomato sauce, look for a short, clean ingredient list with no added sugar.

Nutrients in Tomatoes 

Tomatoes constitute mostly of water and they contain essential vitamins including: 

Vitamin C: supports immune function and promotes protein synthesis. Both of these mechanisms reduce your risk of disease. 

Potassium: helps to regulate cardiac function and can help lower blood pressure. People with lower blood levels of potassium may be at a higher risk for type two diabetes.

Lycopene: is an antioxidant that gives tomatoes their red color. It is being researched for its potential role in weight management. 

A 2019 study tested the potential weight loss benefits of lycopene supplements on obese mice. The results indicated a positive correlation between lycopene supplements and observed weight loss. While human trials need to be completed, it is a promising area of research. 

Unflavored canned tomatoes and tomato juice products all carry similar nutrient profiles. The most significant difference between products is the fiber content. Tomato juice has much lower fiber compared to canned and fresh tomatoes.

Can Tomatoes Reduce Insulin Resistance?

Your pancreas produces a hormone called insulin, which is responsible for clearing sugars out of your bloodstream. 

Insulin resistance means your insulin hormone is no longer able to efficiently clear sugars and your blood glucose levels can rise. 

Researchers have been studying the link between tomatoes and blood sugar improvements in people with diabetes since the 1990s. Scientists have found bioactive compounds in fresh and cooked tomatoes that reduce oxidative stress related to diabetes. 

Oxidative stress is when the free radicals in your body outnumber the antioxidants. Free radicals are harmful to your health and an abundance of these molecules increases the risk of developing different diseases. 

Although the data is promising, no studies exist yet on the link between tomatoes and blood sugar control in people without diabetes. 

Potassium and Insulin Secretion 

Some observational studies have demonstrated that lower potassium levels may increase your risk of diabetes. This is because potassium channels affect pancreatic beta cells, which are involved with insulin production and secretion. 

Your body regulates your blood potassium levels through biochemical signaling, but the resources must be replenished. Eating potassium-rich foods, such as fresh or cooked tomatoes, is recommended to help you satisfy your potassium requirements. 

Other Health Benefits of Tomatoes 

Phytochemicals are natural chemical compounds found in different plant-based foods, including tomatoes. It’s speculated that phytochemicals can decrease your risk of developing certain types of cancer. 

In 2021 a large-scale meta-analysis reviewed all high-quality studies that investigated any link between phytochemical intake and colon cancer incidence.

The data showed a positive link that people who ate a diet rich in phytochemicals had decreased incidence of colon cancer compared to people who consumed fewer phytochemical-rich foods. 

How to Add More Tomatoes to a Healthy Diet

Tomatoes are versatile and can be eaten on their own or mixed into your favorite dishes. Pair them with protein-rich or fiber-rich foods to delay digestion and minimize any impact on your blood sugars. Try these tomato-forward ideas: 

Tomato slices on a grilled cheese sandwich, made with whole grain bread.

Sautée tomatoes and spinach into your breakfast omelet.

Tomato salad with three different varieties and colors, and add legumes for protein. 

Stock your pantry with canned (no sugar added) tomatoes. 

Add canned tomatoes and tomato paste to your next soup or chili dish. 

Swap out fruit juice for unflavoured tomato juice. 

As you explore adding more tomatoes into your cooking, consider choosing specific varieties for your dishes.

Try This Famous Tomato Salad 

A famous tomato salad, that aligns with the Mediterranean diet, is the Caprese salad. It has simple instructions and is blood-sugar friendly: 

• Cut 1-2 ripe tomatoes into slices 
• Cut 8oz fresh mozzarella into ¼” slices
• A handful of fresh basil leaves
• 2 tablespoons each of olive oil and balsamic glaze to dress the salad 

Layer your ingredients in a repeating pattern: tomato, mozzarella, and basil. Repeat the pattern until you have used all your ingredients. Drizzle olive oil and balsamic glaze over your salad. You can add a pinch of salt and fresh ground pepper if you want. 

Are There Downsides of Eating Tomatoes? 

People who suffer from acid reflux or who are recovering from an ulcer are advised to limit their intake of tomato products. The high ascorbic acid in tomatoes can aggravate symptoms and worsen feelings of heartburn. 

This recommendation includes all tomato products, including tomato sauces, salsas, and tomato juice drinks. 

Can You Eat Too Many Tomatoes? 

There is no scientific literature to suggest how many tomatoes are safe to eat in a day. You should listen to how your body responds to tomatoes and make a decision that feels right for you. 

Are Green Tomatoes Safe to Eat? 

There are two circumstances when you would encounter a green tomato: the first is an unripe red tomato, and the second would be a variety of tomato that grows green with stripes. 

Both of these are safe to eat, but the unripened tomato will lack flavor and nutrients. 

A true green tomato has a tart flavor that offers more crunch than a regular red tomato. Green tomatoes are normally cooked before eating and used in salsa, or they are breaded and fried. 

While fried tomatoes are delicious, they are also higher in fats and carbs. You can try making them in the airfryer or grilling them instead. 

Tomatoes and Blood Sugar: Key Takeaways

Tomatoes are nutritious, and they are loaded with essential vitamins and antioxidants. They have low sugar content and should not cause your sugar levels to increase. 

You can rely on fresh tomatoes or canned options in your diet. Choose unflavored canned options whenever possible and always read the ingredients before buying. 

If you suffer from acid reflux you should wean back on tomatoes until your symptoms subside. 

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Have a great week, everyone, and thank you for your support!

Blessed be… and happy cooking!

                                                            Chef Michael R

 

Weekend Ramble: Is Any Amount of Alcohol Okay for Your Health?

I'm quite sure this Ramble will not be fun for many of you. Heck... I'm a hobby wine maker and I'm totally not happy with myself for having read this interview.

During our 2024 road trip (5 weeks) I drank way more than I should have. Drinks of choice were Bloody Mary and Gin & Tonic. My labs a month after returning home were all fine except for my A1C that had reached a level that scared me. I knew right away it had been the alcohol because the rest of my diet had remained the same, even on the road.

Long story short... I knew what had to be done and made the adjustments, but in the back of my head I could not get rid of the scare.

In perusing University Hospital's health blog the title of this piece naturally jumped out at me. I read it. All of it. And I don't like it. Chances are you won't either. But it's important that we understand how even moderate amounts of alcohol affect our body's systems. 

I'm not gonna preach. I will say READ THIS... and think about yourself and your future as someone with diabetes.

Blessed be, friends.

Is Any Amount of Alcohol Okay for Your Health?

April 23, 2024 - An interview with Ryan Marino, MD hosted by Macie Jepson and Pete Kenworthy of University Hospitals.

Research is growing every day about the health risks of drinking. From heart health to cancer to damaging the immune system and sleep quality, even small amounts of drinking may be harmful. Medical toxicologist, Ryan Marino, MD, explains alcohol’s impact and whether any level of consumption is a healthy choice.

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Macie Jepson
Abstaining from alcohol has a moment when dry January rolls around every year, and now we’re hearing a lot about Sober October as well. The topic comes up among my friends, probably yours too. It comes up at work. It’s all over social media. In fact, I’m pretty sure the whole idea was born from social media. And we get expert advice about giving our bodies a break from alcohol from just about anybody.

Pete Kenworthy
Yeah. A lot of that advice focuses on giving our liver a break. And that makes sense. I’ve actually had a couple of friends die from what I believe was drinking too much. Maybe organ failure. I don’t know the medical part behind it, but it got us to thinking, can we do long-term damage to other parts of our body? Now, common sense tells us the answer is yes, but how so? And what does that mean for our long-term health? Hi, I’m Pete Kenworthy.

Macie Jepson
And I’m Macie Jepson, and this is The Science of Health. So many questions here and today we are leaning on Dr. Ryan Marino for the answers. He’s a medical toxicologist at University Hospitals in Cleveland. He specializes in addiction, also emergency medicine. Thank you for joining us today.

Ryan Marino, MD
Yeah. I’m glad to be here.

Macie Jepson
Now, your title tells us that you’ve seen a lot on the job, likely at the acute end of our actions, the consequences for our actions. So for this conversation, we’re going to focus on the long-term medical effects of alcohol consumption, but I feel like we really have to start from the beginning. So what physiologically happens when alcohol is metabolized, when it goes through our bodies?

Ryan Marino, MD
So alcohol has pretty wide ranging effects on almost every organ system in the body. And something that has been coming out more and more in recent years is kind of that it has toxic effects on almost every tissue and cell line in your body. So the main things, I mean, I think in terms of consuming some alcohol, having one drink, one glass of wine, that kind of thing, it first gets absorbed and alcohol is absorbed very quickly where it then gets into your bloodstream and goes to your brain primarily where you get kind of the effects ranging from maybe feeling a little relaxed to all the way to intoxicated, but it is metabolized in the liver. It gets broken down and then cleared from the body, but it kind of touches everything else along the way just because it is going through your entire bloodstream.

Pete Kenworthy
My guess is there are variables that matter. Alcohol doesn’t impact everyone the same way. So what are those variables? Like do things like your weight, your gender, your age, do all those things come into play when in terms of the impact that alcohol has?

Ryan Marino, MD
Yeah. I mean all the things that you just brought up from weight to gender to even your body composition, age, how hydrated you are, your nutritional status, all of those things can play a role.

Pete Kenworthy
So let’s go through them kind of one at a time. If your weight is lower, you feel the effects of alcohol more quickly. This is common knowledge, right? Because you have less tissue to absorb alcohol. Is that it?

Ryan Marino, MD
Yeah. If you think of alcohol, I mean, as a weight-based drug basically, one glass of wine is going to affect a smaller person more than a bigger person.

Pete Kenworthy
And so that’s why it affects women more quickly than men because averages are, women are generally smaller than men?

Ryan Marino, MD
That’s actually one of the reasons. There’s also differences in kind of the water content throughout the body in women and men as well.

Pete Kenworthy
And how about age? Because as you get older, are you at a higher risk of more detrimental impacts from alcohol?

Ryan Marino, MD
Yes. More likely to have kind of adverse effects from alcohol, probably the more we age.

Pete Kenworthy
So you talked about alcohol going to our brains. It changes our mood. It changes our behavior, but what is it doing specifically to our brain and what is the harmful side of that?

Ryan Marino, MD
Yeah. So alcohol has a number of effects and the main reason that people feel kind of relaxed and disinhibited and can even end up intoxicated is because it acts on your GABA receptors. And so if you think of GABA as being kind of the primary neurotransmitter that causes like relaxation, like benzodiazepines are a medication that would do the same kind of thing. Alcohol also acts on glutamate, which is the body’s main excitatory neurotransmitter. And so it blocks that and so kind of doubles up the effect. And so over time, I mean, your body, if you are drinking frequently every day, your body gets used to this and will kind of change the amount of these receptors and neurotransmitters that it’s making. And so if you take the alcohol away, you may be kind of functioning at a more excited neurologic state. And the pathologic or disease form of this would be alcohol withdrawal. But that also is the reason why people who drink regularly can get things like high blood pressure and can get mood changes and other psychiatric and psychologic features from this as well.

Pete Kenworthy
Are there physical damages that occur in the brain though?

Ryan Marino, MD
Yes. Alcohol itself, I mean, can cause damage to every cell and tissue. The effects that you feel in the short term and the kind of long-term changes aside, your brain can actually shrink over time from a lot of alcohol consumption. And the alcohol itself can cause brain damage, especially in like large overdoses, I guess I would say, consuming, binge drinking, that kind of thing.

Macie Jepson
You mentioned changes your cells and your tissues. Is that why we hear and read in the headlines that excessive alcohol consumption can lead to cancer?

Ryan Marino, MD
So that is the main reason. I mean, if you think of, I’m trying to think of a good example here, like rubbing alcohol is a form of alcohol, but if that touches any like open skin or say you got it on your mouth or something, that is very painful just because the kind of composition of alcohol is damaging to those cells in your mouth, your mucus membranes. And so when you drink alcohol, there is some sort of damage being done and that’s why oropharyngeal, the head and neck, esophageal cancers and stuff can be associated as well. But it seems like kind of almost every form of cancer may be affected by alcohol in some way. We’re seeing colon, breast, all of these other different forms that aren’t just from the direct contact with alcohol.

Macie Jepson
We’re going to continue to talk about the different parts of the body, but I want to also touch on something you just said that I feel like this is a good time to talk about the elephant in the room. You talked about binge drinking. You talked about excessive drinking. In your experience on the front lines, do we have a problem in America?

Ryan Marino, MD
Yeah. There is a lot of alcohol consumption here and it seems like especially since the pandemic, the amount of kind of heavy drinking, not necessarily binge drinking but binge drinking as well as heavy chronic drinking seems to have gone up. And I don’t know that anyone has a good answer for why this is happening, but if you think of kind of American culture has always been kind of work hard, play hard, like the weekend warrior mindset. And I think we have a very strong hold from our alcohol industry on marketing and different kind of cultural events as well. So it kind of makes sense that this is happening, but it does seem to be a uniquely American phenomenon in a lot of ways.

Macie Jepson
And what are you seeing as a physician? Are they coming through the emergency room? Are they coming to you for an appointment and saying, what have I done? What does that look like?

Ryan Marino, MD
It can be a lot of different ways people can come in saying, I have kind of lost control of my drinking and I want help with it. And we’re seeing a lot of that. I mean people are like, I just didn’t know how it got to this point where I’m now drinking all the time. But also seeing a lot of the effects of people having these binge episodes especially, I mean, can have very immediate health effects. And then the long-term effects take probably more decades to really cause things like the severe liver damage, but certainly still seeing that all the time as well.

Pete Kenworthy
Before we get on to the, you mentioned liver damage and we’re going to go on to some other body parts, too, but while we’re here talking about drinking, and my guess is everybody’s got their own definition of the things you’re talking about, right? Drinking too much. My definition of that is different than your definition of that, but there’s a clinical definition of that is my guess, that what is really too much, right? We’ve heard a lot. One glass of red wine a day is fine. That’s kind of what we’ve heard. So people then interpret that as well, two’s not bad then or one liquor drink. Or people start making their own assumptions about alcohol. And we were going to kind of reserve this for the end, but it seems like this is the time to talk about it. What is okay? What from a clinical standpoint is okay or is the answer none?

Ryan Marino, MD
Yeah, that’s a great question because this has been changing so much in recent years and most recently, I believe the CDC has said that one drink or fewer per day for women and two drinks or fewer per day for men is okay. And they define that as one glass of wine being five ounces, one beer being 5% and 12 ounces and one shot of hard liquor. But in the kind of long term, that little snapshot of one day also doesn’t apply to, it doesn’t mean that drinking every day is okay. And more and more, as more data comes out, that very clearly shows that any amount of alcohol is detrimental. It seems like the recommendation is moving towards no amount is actually considered safe. And so it’s not like that one glass of wine at dinner is going to give you cancer per se. It’s just that there is no amount that is without any risk. And so minimizing it like dry January, I mean, if you can go 31 days without drinking, that’s great. And if you’re someone who drinks every night, maybe if you can go every other night or something, any little change is going to make a big difference.

Macie Jepson
Let’s continue with our trip kind of through the body and kidneys. It makes sense to me. So please explain that. Lungs surprised me. How does drinking affect that?

Ryan Marino, MD
Well, so interestingly enough, one of the ways that alcohol leaves your body is you actually breathe it out through the surfaces of your lungs. And so that’s something that comes up for me more often when people drink the toxic alcohols that I have to worry about getting them some sort of antidote or something because if we block other routes of metabolism, that’s the only way they can get it out is by breathing it out. But for regular alcohol, that is one of the ways and because it is just traveling through your bloodstream, it ends up getting to anywhere that blood is reaching.

Pete Kenworthy
And the other way it gets out has to do with the kidney, right?

Ryan Marino, MD
I mean clearing the metabolites of alcohol and even alcohol itself, I mean, comes out in your urine. You can test if someone has been recently drinking because there’ll be alcohol in their urine. But that’s where it all ends up being filtered out.

Pete Kenworthy
And kidney disease can result from that.

Ryan Marino, MD
Mm-hmm.

Pete Kenworthy
So when you think about drinking anything, not just alcohol, and you actually already mentioned this a little bit ago, the liquid goes in your throat, your esophagus, then your stomach, all those things. You mentioned oral cancers coming from alcohol, but throat, esophagus, stomach, these all can be impacted by alcohol as well?

Ryan Marino, MD
Yeah. In recent years I think rates of those cancers have been going up and there’s certainly other reasons that people can get those, but we’ve seen, I mean, smoking has gone down in the past few decades and with drinking going up, it kind of makes sense that those would be coming back up again.

Pete Kenworthy
So the liver is the one we hear about the most. Can you tell us what happens there? I mentioned at the beginning of the podcast a couple of my friends have passed away and at least one of them I’m pretty sure was “organ failure.” So I assume that’s the liver. What happens there? Why does it fail? How much does it take for something like that to happen?

Ryan Marino, MD
So the liver is the primary source or site of alcohol metabolism. And so to get the alcohol out of your body, it goes into the liver. The liver kind of uses it actually for energy and so metabolizes alcohol into various products. And the liver without alcohol present is usually going to be metabolizing fatty acids, which is a very important part of your kind of metabolism. And so for people who are drinking chronically, and this would be every day and really kind of all the time having alcohol always in their system, the liver completely changes its primary source of metabolism from fatty acids to alcohol. And so when it stops metabolizing those fatty acids, it then starts storing fat. And so people start getting fatty liver. And this is very inflammatory to the liver itself, leads to scarring down the road. And that eventually leads to, I mean, the scars kind of take out the functionality of the liver and so you can get full-blown liver failure, but this is usually something that will take decades to develop and really requires kind of pretty prolonged and heavy use. And so even for people who like I’m sure everyone knows that one person either in their family or friends or someone who drinks a lot, probably way too much and does so for many years and has no issues, it seems to only affect like a smaller number of these people, but there’s no way to predict that risk. And so even though I know someone who drank for 90 years and never developed liver failure, it doesn’t mean that I would ever want to take that risk myself.

Macie Jepson
So cirrhosis is what we hear about and it seems to be the scariest, but at the same time, the liver regenerates. Isn’t it one of the most regenerating organs in our body?

Ryan Marino, MD
Yeah.

Macie Jepson
So how does that work?

Ryan Marino, MD
The liver has pretty incredible powers of regeneration, can recover from a lot of insults, I mean. We even hear now about how you can donate a lobe of your liver to someone and you can grow them a whole new liver for transplantation. Cirrhosis, the term is for the amount of scarring and damage to the liver from alcohol that is considered irreversible. And so there is kind of a point where it’s too much to recover from. And that isn’t to say that there isn’t any hope or cirrhosis is the end of the road because if you are diagnosed with cirrhosis or someone you know is, there are plenty of things you can do to slow the progression to stop any further damage. But the road to cirrhosis is also very long. And so that fatty liver, the steatosis, the scarring, the fibrosis, those things can be identified earlier and those you can recover from a lot of the time. And especially as soon as you stop drinking, the fatty liver and that kind of stuff can start to resolve. The liver can regenerate and go back to functioning the way it wants to.

Macie Jepson
So to be clear, there are a lot of steps along the way towards cirrhosis. Your one month off in January isn’t going to reverse that, but we really want to inform people with the facts because on social media in January they’re talking about that one week your body looks like this. In week two it feels like this. Break it down for us.

Ryan Marino, MD
Yeah. That is always tricky because I mean people can have great effects and can start to see benefits right away. And I don’t want to say that you shouldn’t hope for that or you can’t have that, but when I hear that week one, your sleep will be better, week two, your skin will look fresher, all that stuff. I mean it’s really hard then for people who don’t get those results right away. And to just remember that the changes happening in your body are definitely happening even if your sleep maybe isn’t fixed right away, if your skin isn’t changing that kind of thing. On the inside, I mean the livers can go back to metabolizing the fats that it wants to and not storing them. And those kind of cellular level changes, all of that, your different organs can start healing themselves, that kind of thing.

Pete Kenworthy
Can everything in the body start healing itself to some extent? And I realize there’s a lot of subjectivity here. It depends on how much you drank and for how long, but if we’re talking about those people who are drinking every day or maybe drinking a handful of times a week, more than the average person, and they’ve done some damage to some parts of their body, can all those parts recover?

Ryan Marino, MD
For the most part, yeah. I mean there’s definitely some degrees of damage that can be irreversible. And so I mean the liver isn’t the only one. You can get enough damage to your heart and the heart muscle that may not be able to recover. But stopping is the best chance at any improvement. And I think one good example that we didn’t touch on that’s worth bringing up is the pancreas. And so pancreatitis, which is a horrible, painful condition, people have bad abdominal pain and vomiting is primarily caused by alcohol. That’s the number one cause. But as soon as people stop drinking, that inflammation immediately starts to resolve. And on the flip side, we see that I mean, if people go back to drinking, you can immediately have recurrence of that. So it is good to remember that on the inside things are healing and can get back to kind of their baseline state even if you don’t necessarily see the changes on the outside.

Macie Jepson
And going back to drinking, that’s what I often think about. You’ve given yourself a break, your body’s ticking along, maybe healing itself a little bit, and then come February or whenever you decide to jump right back in, it’s got to be a shock to the body. That can’t be good, right?

Ryan Marino, MD
I think though, I mean any amount of that kind of time off and healing is good and it seems like at least in terms of dry January, but when I’m talking to people who are just trying to quit drinking for other reasons or trying to cut back on their drinking, having that time away from alcohol beyond just letting your body kind of reset. And it also will help if you feel like you’re drinking a lot because you’ve developed tolerance, that tolerance can go away. And so if you started drinking again, you hopefully wouldn’t need to drink as much, but it allows people time to consider their relationship with alcohol. And so a lot of times, I mean people are drinking just because it’s something to do because we’ve associated with so many events, but other times people may be drinking because they’re having trouble sleeping, dealing with anxiety, stress, that kind of thing. And so having time without the alcohol on board to deal with whatever that is and kind of think about why you were drinking in the first place, seems to, at least in my anecdotal experience, help people if they do start drinking again or not completely stop in terms of reevaluating how much or why they’re drinking in the first place.

Macie Jepson
You mentioned better sleep, not necessarily the case with alcohol. So can we talk about some other effects of quitting for a while? I read libido. I mean that should be enough right there to make some people want to stop drinking.

Ryan Marino, MD
Yeah, I mean, these all are, I would want to put a caveat on that they are potential benefits, but people might not see them right away or might not see the same benefits as everyone else. And sleep I think is a great one because this is one that comes up in social media posts, especially with dry January. It’s like my first week I had endless energy. My second week I slept like a baby, that kind of thing. And for people who have like problem drinking or have been drinking for a very long time, we actually see a lot of disorders in kind of sleep. And those can actually be worse when people stop drinking. So alcohol itself is bad for your sleep because it disrupts your REM cycles. And so even though it may help people fall asleep, it may help people get a full night’s sleep, they’re not getting the same kind of quality sleep, and so your sleep will improve when you take the alcohol out of the picture.

But for a lot of people who really have been struggling with issues with alcohol, their sleep might be even worse after they stop drinking. And that is hard to kind of talk people through, especially when it comes to comparing yourself to these fantastic results that you see in a TikTok video because it will get better eventually. But yeah, your blood pressure can go down almost immediately. Even just reducing the amount you drink can start lowering your blood pressure. Libido can return and can improve for people who have been drinking for a long time, but again, in the short term may actually be even worse. So it is hard to kind of coach people through that when they’re expecting great results and not seeing them. But there’s a great chance that people could see those results right away.

Macie Jepson
But it could be a long-term commitment for some people to really, a commitment to pull away from alcohol significantly.

Ryan Marino, MD
And to undo a lot of these kind of changes in the body, especially if someone has been drinking for a very long time, it may take more than just a month. It may take months, three to five months even, to see some of those changes.

Pete Kenworthy
My guess is, I was going to ask you what the first signs are of alcohol damage to your body, but my guess is if you see the signs, it’s too late?

Ryan Marino, MD
It’s not that it’s too late, but it is one of those things where for the most part, there isn’t going to be any sort of outward sign. So I, I feel like I keep saying the same phrase where we probably all know someone, but I’m sure everybody knows that person who drinks way more than seems healthy and doesn’t have any sort of outward signs. They’re not unhealthy seeming. They’re not sick. They’re not having trouble with their job, their life, that kind of thing. But yeah, it can be kind of a later thing. It can be more of a masked illness, so to speak, or a hidden illness. But in terms of things to watch for, I mean, I think high blood is one of the earlier things that develops, that kind of thing. Mood disorders as well.

Macie Jepson
If you’re looking for jaundice, that’s probably a little late.

Ryan Marino, MD
Yeah.

Pete Kenworthy
Can you tie a bow on this and with advice really for everyone, right? People who haven’t started drinking or maybe early drinkers, people who’ve been drinking for 20 years, people who’ve been drinking for 50 years, what should all those people know that maybe people don’t know? We know alcohol can have long-term impact, certainly on your liver. We just went through a bunch of other body parts, but what’s the takeaway about alcohol? It’s not pure evil, but it’s not pure joy either.

Ryan Marino, MD
In terms of kind of takeaway points, it’s never too late or too little to try to reduce the amount that you’re drinking. So I mean, if you can cut back one drink or stop for one month or completely stop, all of those things are going to have some sort of health benefit. And even if you are someone who has cirrhosis stopping drinking, it’s still not too late for that. There still is a benefit. I think in terms of the other takeaway on kind a flip side is that, I mean, I remember for the past few decades just hearing health benefits from red wine. It’s great to have one drink a day, that kind of thing. And really within the past couple of years we’ve seen the complete opposite of that is true. And there is very good data that shows that just any amount of alcohol is going to have some potential for harm. And so it’s not that you should be scared and cut out the glass of wine with dinner or getting beers with your friends, but just remembering that there is no amount that is going to be good for you per se.

Pete Kenworthy
Dr. Ryan Marino, toxicologist and addiction specialist from University Hospitals in Cleveland, thanks so much for joining us.

Ryan Marino, MD
Yeah. Thanks for having me.

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