Newsletter – December 2018

A Stroll After Supper Is Good Advice for Type 2 Diabetes Patient

Kristin Jenkins

Two new studies provide more evidence that exercise is critically important for both the prevention and management of type 2 diabetes.

In the first, researchers conclude that telling patients with type 2 diabetes to “Take a short walk right after meals” may be one of the best exercise prescriptions a clinician can give.

Results from the randomized crossover study show that postmeal blood glucose levels dropped 12%, on average, when patients with type 2 diabetes walked for 10 minutes after three daily meals compared with walking for 30 minutes at any time of day.

Most of this effect came from a 22% glycemic drop in the 3-hour period following the after-dinner walk, particularly when the meal was carbohydrate-heavy, say Andrew N Reynolds, MD, from the University of Otago in Dunedin, New Zealand, and colleagues.

“The improvement was particularly striking after the evening meal when the most carbohydrate was consumed and sedentary behaviors were highest,” they say in their paper published October 17 in Diabetologia.

Since postprandial glycemia is an independent determinant of glycemic control as well as cardiovascular risk, the timing of physical activity may provide significant additional health benefits to patients with type 2 diabetes, Dr Reynolds and colleagues point out.

The findings also make a strong case for updating current guidelines, the researchers assert.

“The benefits relating to physical activity following meals suggest that current guidelines should be amended to specify postmeal activity, particularly when meals contain a substantial amount of carbohydrate.”

Current activity guidelines recommend that patients with type 2 diabetes get a minimum of 150 minutes of moderate physical activity each week, or about 30 minutes a day over 5 days. Daily exercise can be completed at one time or at different times throughout the day.

Postprandial physical activity may make it possible for patients to avoid an increased total insulin dose or additional mealtime insulin injections to lower glucose levels after eating, Dr Reynolds said in an interview.
Higher insulin doses might, in turn, be associated with weight gain in patients with type 2 diabetes, many of whom are already overweight or obese.

“What is surprising is how easily this advice can be communicated to patients with type 2 diabetes,” he told Medscape Medical News. ” ‘Go for a walk after your meals’ ” is a very clear message to deliver to your patients and then to follow up at each subsequent clinical visit.”

Since the prescribed level of activity was so modest (30 minutes total each day), the results may be applicable to a wide group of patients with type 2 diabetes mellitus, Dr Reynolds added.

The researchers are conducting follow-up research to identify factors that motivate or prevent people with type 2 diabetes from following a regular walking prescription, which they hope will be of use to physicians to help promote adherence to regular walking routines; they expect to publish this work soon, Dr Reynolds said.

More Exercise Always Better When It Comes to Preventing Diabetes

Results from the second study further inform when it comes to the dose-response relationship between exercise and the development of type 2 diabetes.

This was a meta-analysis of 23 cohort studies in 1.2 million nondiabetic individuals from the United States, Asia, Australia, and Europe, showing that those who achieved a 11.25 metabolic equivalent of task (MET) hours/week of moderate activity (the 150 minutes/week currently recommended) had a 26% reduction in the risk of developing type 2 diabetes.

Those whose physical activity reached 60 MET hours/week, however, reduced their risk of developing diabetes by an even greater amount, more than 50%, said lead author Andrea Smith, a PhD candidate in public health at the Health Behaviour Research Centre at University College London, United Kingdom, and colleagues.

The work is also published on October 17 in Diabetologia,

“Our study favors a ‘some is good but more is better’ guideline, in which specific targets are mainly used for a psychological effect,” say the researchers.

“There is no clear cutoff at which benefits are not achieved, and health benefits increase at activity levels well beyond current recommendations.”
Funding for the New Zealand study was provided by the University of Otago and the New Zealand Artificial Limb Service. Funding for the UK study was provided by the Centre for Diet and Activity Research (CEDAR). The authors from both studies disclosed no relevant financial relationships.

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Diabetologia. Published online October 17, 2016. Reynolds abstract, Smith abstract

New Maintenance Protocols

We know that all of our patients start the Dr. Bernstein weight loss program with the best of intentions to follow it as strictly as possible, but we also recognize that our patients may face a variety of life events that can periodically interrupt their routines or conflict with their efforts to adhere to the program properly.

So we have made it easier for you make adjustments to your goal so that you can deal with the issue of the moment without letting go of the program and the weight loss progress that you have made.

We have removed and relaxed some of the protocols around the Maintenance Program so that patients can shift from the strict program to maintenance at any time, and for as long as needed. You will still enjoy the benefit of being able to visit with the nurse once per week to review your progress and health, and learn what you should and should not be eating at various stages of Maintenance. And of course, we will always be here, ready to encourage and support you when you are ready to get back on the weight loss program, all the way to your goal!

Look and Feel Great for the Holidays

The holiday season is fast approaching, and all of the associated social functions are right around the corner. By starting The Bernstein Diet today, you can lose as much as 30 pounds by the holidays*. Imagine how good you will look and feel with all the extra energy you’ll have to participate in holiday activities.

If you’re already on the program, the challenges of the festive season make regular clinic visits all the more important to your continued success. Our nurses and doctors can give you the tips and motivation you need to stay focused on your goal through the holidays. And if you find you need a little more support, remember that you can visit the clinic every day at no extra cost.

Are you a former patient interested in returning to the program for a Tune-Up? Just call us at 1-888-372-3438 or use our Contact Form and we’ll get you back on track as quickly as possible.

Everyone at Dr. Bernstein Diet & Health Clinics wishes you a very happy and healthy Holiday Season!

*Individual weight loss may vary. Call for details. Compliance with our program is required.

Food Bank Donation Drive

Recipe of the Month: Veal & Spinach Terrine

Tips for Using the Bernstein Diet Mobile App

The Bernstein Diet Mobile App is here to help track your weight loss journey. Patients can access log in to access Recipes, Food List, Weight Tracker & BMI Calculator!

Login Quicker
After you log in with your portal.drbdiet.com username and password, open the menu and go to the Settings area. Here, you can set the app to automatically log you in when you open the app, without re-typing your password each time. You can also choose how often you want to check for food list and recipe updates. Checking less frequently will make logging in much faster

Share Your Thoughts
You can click on the five stars when viewing any individual recipe to give it a rating. The recipe will show the average rating given by yourself and all other patients.

Personalize Your Weight Tracker:
If you would like to add a photo or a message to a date on your weight tracker, you can tap on the dot in the graph for that day to edit it. You can also include a photo or message when adding a new day to your tracker.

Get it now!

Android phone or tablet (4.1 or higher): Click here
iPhone, iPad & iPad Pro (iOS 8 or higher): Click here

We’re Hiring!

Clinic Support & Administration

We are always looking for skilled people to join our team. Opportunities exist for personal and professional growth, in one of our administration and support team positions. Your chance to make a contribution to our patients’ success range from entry level to management positions in areas such as: Finance; Human Resources; Contact Centre; Warehousing/Logistics; Operations & Nursing Support; & Information Technology.

For a list of current openings, and to apply online, visit the following link: https://www.drbdiet.com/clinic-support-administration/

Physicians

Are you ready for a rewarding change of pace? With our dedicated and streamlined approach to patient care and clinic operations, the convenience of regular day-time working hours and attractive compensation, we present a significant lifestyle opportunity for today’s doctors. All while making a positive difference in so many of your patients’ lives. For a list of current openings, and to apply online, visit the following link: https://www.drbdiet.com/physicians/

Nurses & Medical Receptionists

Are you tired of working unstable shifts & weekends? Are you looking to improve the balance between your work and family life? If you answered YES then we have the opportunity for you! As part of our highly skilled team, you will be closely monitoring our patients’ health, educating them on proper nutrition and motivating them to achieve their goals and maintaining their healthy weight for the rest of their lives!. For a list of current openings, and to apply online, visit the following link: https://www.drbdiet.com/nurses/