Janice Shigehara, RD, CDE

It is customary to ask a person if he/she got their exercise session in for the day.  In the future it may be, how much time have you spent on your feet.  A recent study of people with Type 2 diabetes is causing us to question the notion that the duration and intensity of exercise are sufficient to assess whether a person has had enough exercise.  When the group of study subjects  were on their feet more (walking 2 hrs and standing 3 hrs per day broken up over the course of the day) they reduced their blood sugars 36 per cent more in a 24-hour period than when they only stood 1 hr. and walked 1 hr.  They also decreased their insulin resistance over a 24 hr. period more than when they biked for 65 minutes all at one time.  Turned out that when biking, the group was sitting more overall, than when the group was walking/standing for the total of 5 hrs.


The conclusion is not to give up the cardiovascular activity which, in the study improved glucose levels as did the walking/standing group, but consider ways of reducing overall sitting time, since the walking/standing group also experienced less insulin resistance, so overall better glycemic control.  This study involved people who have diabetes but could, if confirmed by other studies, help reduce the development of type 2 diabetes, since insulin resistance is a large factor in the development of type 2 diabetes.


So, the challenge is to find ways to build more activity into our routine, whether it be standing when talking on the phone or getting up every 30 minutes from a sitting position, as the study group did, to walk or to do a few exercises, taking stairs instead of elevator, parking farther away, etc.   We are all likely to benefit from less sitting time, whether it be improved bone density, joint mobility, cardiovascular benefits (blood pressure), body fat, better sleep, or even just from an improved sense of well-being.

The latest guidelines for Americans, recommends limiting added sugars to 10% of calories.  For an average adult who needs 1800-2200 calories, this is 11-14 teaspoons of added sugar per day.  Keep in mind, that “added sugar” does not apply to foods high in natural sugar such as milk, yogurt, bread, unsweetened cereal, rice, beans, all  vegetables and unsweetened fruit.  Added sugars. or “empty calories” which have no nutritional value contributes to extra calories and extra weight which can  put us at risk for diabetes and heart disease. A 12 ounce can of soda has 9-12 teaspoons of sugar.

We consume about half of  our calories from added sugars from sodas, juice drinks, flavored coffees and teas and pastries and candies. Here are some practical recommendations to begin reducing your sugar intake:  Drink water in place of sugary drinks. Don’t like plain water?  Add some flavor, by putting a few cucumber slices, lemon slices or a few strawberries in your water. Buy a “fun size” or regular candy bar instead of the large bar or the entire package of candy.  At the office or at home, keep fresh fruit or natural fruit cups, baby carrots, prepackaged natural peanuts, and single serving raisins in your desk drawer or on the counter at home.  Craving ice cream?  Go out to purchase one cone or better yet, buy your ice cream in a cup.

A healthy diet consists of a variety of protein, fats and carbohydrates for essential nutrients to fuel our bodies. This will help keep your calories in a reasonable range to manage your weight.  The Dietary guidelines were developed by the Department of Health and Human Services and USDA health and nutrition experts after reviewing scientific information.

Many people think unless they have symptoms of diabetes such as excessive thirst, frequent urination, blurred vision, or pain and/or numbness in their feet or hands, they will not develop complications. What is just as important to know is blood sugars can be high without any of the usual symptoms of diabetes and can be doing harm to your vessels in the eye, kidney, heart, or damage nerves leading to the feet or hands, without a person knowing it is happening. According to the California Department of Public Health, in California, approximately 1.5 million or 5% of our adult population has diabetes but doesn’t know it.

Are you aware of the risk factors for diabetes?

1.  Age 40 or older

2. Immediate family member with diabetes

3. Being  obese ( generally 30-40 pounds or more about ideal weight)

4.  Had diabetes during pregnancy

5.  Being Male

6.  Being diagnosed with high blood pressure

7.  Being physically inactive.

If you have 2 or more or the above risk factors, check with your doctor to see if additional testing is needed.  Prevention is the key. With awareness and some simple lifestyle changes, diabetes can be controlled and one’s quality of life can be maintained or improved.  Developing complications can often be minimized or avoided, if detected and acted upon early.

Prediabetes is a condition identified by a blood test your doctor orders.  Many people find out through a routine physical.  If your doctor tells you your blood glucose values are higher than normal, but not high enough to be diagnosed as having diabetes.   It can be diagnosed by 3 different blood tests in the laboratory–fasting glucose test in which someone has not eaten for at least 8 hours, a 2 hour (75 gram) glucose test when you are asked to drink a sugary solution and then a blood is taken to see how your body handles a load of “sugar”, or an A1C or estimated average glucose test which does not have to be performed in a fasting state and reflects the average glucose levels over a 3 month period.


Test                                         Normal                     Prediabetes                  Diabetes

Fasting                                   <100 mg/dl                 100-125 mg/dl             >125 mg/dl

2 hour (75 g) glucose               <140mg/dl                   140-200 mg/dl            >200 mg/dl

A1C(est. Ave. Glucose)           <5.7%                          5.7-6.4%                    >6.4%


Coconut Oil
Coconut oil is made from coconut milk or dried coconut
meat. It is used in a variety of settings, including cooking, skin
care, and even as an alternative fuel source, just to list a few. It
has been a staple in tropical regions of the world for thousands
of years. Dietitians have known and used coconut oil for some
time now since it has been used medically in individuals with
compromised fat digestion or sensitive gastrointestinal tracts.
It usually comes in a jar and it is commonly hardened, or as a solid. It quickly
changes into liquid form (oil) when heat is applied. Coconut oil, as with coconut milk,
contains saturated fat, so a moderate intake of coconut oil is recommended.
As consumers, look for virgin coconut oil which contains a type of saturated fat that
raises both good and bad cholesterol levels. So overall we recommend moderation when
consuming this oil while looking for ‘virgin’ on the label.

Coconut milk and coconut milk-made products like yogurt or ice creams are also very popular among vegetarians and  individuals with a cow’s milk allergy or dairy intolerance. Coconut milk is made by grating the meat of the coconut and   collecting the liquid. Coconut milk is high in saturated fat and is an ingredient in many Southeast Asia (Thailand, Malaysia, Indonesia, Singapore, and Philippines) recipes and many cuisines. Let’s remember that saturated fat is a type of fat that raises the level of total cholesterol in the blood, also containing higher calories, so moderation is key.

When dealing with children, parents who prefer coconut milk rather than cow’s milk for their children should realize that cow’s milk contains various vitamins and minerals that are essential for a child’s growth and development. Coconut milk’s is not a substitute for cow’s milk, it is lower in protein, calcium and other nutrients found in dairy milk, that could lead to nutrient deficiencies. As well, the effects of a too much coconut milk in a child is unknown. If children do consume coconut milk, they should also add other foods and beverages to their diet to complement the lack of specific nutrients.


Diane Machcinski, Registered Dietitian

Diane Machcinski, Registered Dietitian


Welcome to my blog!

There is not a greater truism than “you are what you eat”. As an award-winning nutritionist, I’ve helped many people find their way back to healthy diet routines to mitigate medical problems, regain energy, and feel better about themselves.

And, I can help you too! Call me at 858-279-5124 to set up a consultation.