Category Archives: lifestyle

How did I get type 2 diabetes?

source canstock photo

Being diagnosed with type 2 diabetes can be a very overwhelming experience. Naturally, those newly diagnosed may have a lot of questions. But one of the most common questions I get asked is ‘how did I get diabetes?’

 A lot number of people may not have a full understanding of how certain factors as well as lifestyle can put them at a higher risk for developing type 2 diabetes.

 In a recent post -summit survey I performed, several participants responded they wanted to learn more about type 2 diabetes. 

For those people who do not have diabetes, this information is still beneficial. It will help you to know what your risk and begin now to make healthy lifestyle changes.

 Insulin and the pancreas

The pancreas is an organ located in the abdomen. It produces a hormone called insulin. Insulin helps the cells in the body to use sugar as energy.

In type 2 diabetes, the cells of the body begin to resist the effects of insulin. This condition is called Insulin Resistance.

I like to use the metaphor of a landlord who changes the locks to the house on his tenant.

In this metaphor, the tenant is blood sugar.  Insulin controls the lock to the house. With insulin resistance, the tenant cannot open the lock, with the insulin.

Insulin resistance is usually present in the body at least five years before type 2 diabetes is diagnosed.

Who is at risk of developing type 2 diabetes?

 Here are some of the things you should know that increases the chances of developing type 2 diabetes:

  • Family History: A big reason why people develop diabetes is genetic. If you have a first degree relative with diabetes, like a parent, sister, brother,  then your chance of getting diabetes goes up five to ten times. So it is crucial to know your family history.
  • Ethnic Groups: Type 2 diabetes is common in certain races such as African Americans, Hispanics, Asians, and Native Americans. So just by being of a certain race puts you at an increased risk.
  • Pregnancy: 3-5% of pregnant women can develop diabetes in pregnancy, also known as gestational diabetes. The difference is that once the baby is born, diabetes goes away.

If you had diabetes while you were pregnant, you are at risk of developing diabetes later on in life. Make sure that after your pregnancy, you have regular medical check-ups. Your healthcare provider will need to monitor your blood sugars closely.

  • Environmental Toxins:  Environmental toxins which can increase the risk of type 2 diabetes have been coined diabetogens. Exposure to toxins such as pesticides, arsenic, as well as ambient air pollution, to name a few, can all increase the risk of type 2 diabetes through several mechanisms.

Ongoing exposure to the toxin load increases our risk of developing type 2 diabetes.

  • Medications: Some medications can cause diabetes. Usually, this happens to people who were already at risk for developing diabetes.

One of the common drugs that can cause diabetes is steroids. Steroids are used to treat many medical conditions such as transplant patients, chronic lung disease, rheumatoid arthritis, and other autoimmune diseases to name a few.

According to the National Kidney Foundation up to 20% of patients after a kidney transplant may develop diabetes.

There are some other commonly used medications which can elevate blood sugars.

These include-

  • Statin medications -used to treat high cholesterol.
  • Thiazide diuretics -used to treat high blood pressure.
  • Beta-blockers
  • Transplant rejection medications such as tacrolimus
  • edications used to treat anxiety and/or depression.

Speak with your healthcare provider if you are concerned about any medications you are on. Do not discontinue any medications by yourself.

It is possible that the benefits of being on the medication may outweigh your risk of developing diabetes.

Trust that your healthcare provider has your best interests at heart.

If you do not feel this about your healthcare provider, then perhaps you need to search for a new one!

For more information on how to pick a healthcare provider that is the right fit for you, click here.

To download a FREE copy of the first three chapters of my award winning book which explains more about type 2 diabetes, click here.

Here’s to your Health & Wellbeing,

Some proven benefits of the ketogenic diet, but is it right for everyone?

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I recall when I first started hearing the buzz around going “keto” “ketogenic” ketolife” I was very skeptical. With the roll of my eyes I dismissed it as a soon to be done fad that would blow over. But it didn’t.

After my community talks, I’d have a few people stop by and ask my thoughts on going “keto”. Again, my response would be I thought it was just another fad and would pass away. And oh by the way if you happened to be someone living with type 2 diabetes, this probably was not for you!

How wrong I was on both counts especially the latter.  

Well you know the saying “what you resist persists”?  Keto has persisted. And now it’s becoming mainstream.

The ketogenic diet was developed almost a 100 years ago- in the 1920s- by a faith healer who was trying to help children with epilepsy. There was some success with this diet intevention at the time. However, when drugs were developed for the treatment of epilepsy it fell out of favor.

How does the ketogenic diet work?

The ketogenic diet works by converting the body’s source of predominant fuel from carbohydrates to fats which are the source of ketone bodies predominantly beta hydroxybutyrate. This leads to an increase in the production of energy source -ATP.  

The ketogenic diet is now being used to treat a host of diseases and conditions. In the article below I list some of the benefits of a ketogenic diet.

Improved insulin resistance and reduced inflammation

By utilizing fats as a source of fuel versus carbohydrates there is less need for insulin. This leads to less insulin resistance. Insulin resistance is the hallmark of type 2 diabetes. There is research showing the benefits of a ketogenic diet to reverse pre-diabetes or type 2 diabetes. Insulin resistance is also associated with more inflammation because of an increase in free radical production. Inflammation is linked to a host of chronic diseases such as auto-immune diseases, arthritis, thyroid disease, bowel disorders, mental and cognitive decline (type 3 diabetes). Less insulin resistance=less inflammation, which allows the body to heal.

Improved Fat Burning leading to weight loss
By definition, being in a state of ketosis means you’re burning fat for energy. If you have excess body fat, you’ll be able to burn it at a much more efficient rate. This trend can lead to weight loss. The advantage of using fat as fuel, is that you do not have as much hunger cravings as when you are using carbohydrates as a main source of fuel.

Mood stabilizing effects
A ketogenic diet changes the energy matrix of the body. In the brain, a ketogenic diet helps to modulate mood by not only a reduction in inflammation but also changes in monoamine oxidase levels, GABA transmission, as well as mitochondrial biogenesis.

Improved Energy
Increased energy from a ketogenic lifestyle is due to a combination of factors including less inflammation, upregulation of mitochondrial biogenesis, more ATP per molecule of ketone and more stable blood sugar.

Improved Mitochondrial Biogenesis &Anti-aging
Our bodies are trained to use glucose (sugar) as a natural source of energy.  Our mitochondria are the energy powerhouse of our bodies. With aging, we tend to have less efficient mitochondria. The ketogenic diet helps to stimulate new and stronger mitochondria. Because mitochondria have such a profound impact on energy production, inflammation levels and gene expression (and therefore an overall function of the body), promoting mitochondrial health can be of great benefit when it comes to anti-aging.

How do you know you’re in ketosis?

There are a number of kits on the market which can help you to detect when you are in ketosis. Kits that measure blood levels are more accurate than urine test strips.

How do you know if keto is right for you?

Despite it’s popularity a ketogenic diet may not be safe for everyone. Despite a plethora of websites offering do it yourself keto plans and diets, I highly recommend that you invest in working closely with a qualified healthcare professional who is well versed on what to look out for if you have any of the following conditions:

  • Type 2 diabetes
  • Very high blood triglycerides
  • Severe depression
  • Older adults
  • Cancer
  • Cognitive decline such as alzheimer’s type dementia
  • Certain gene snps such as ApoE4

The next thing to consider is – how long do you need to be on a ketogenic diet?

The reality is that maintaining ketosis for prolonged periods of time can be a challenge for most.

In summary, a ketogenic diet can be a useful tool for helping to improve metabolic health. Be sure to use it under the supervision of a qualified healthcare practitioner who will be able to customize it to your unique goals as well as determine a safe duration of therapy.

To your health and wellbeing,

Scientific citations

A low carbohydrate ,ketogenic diet to treat type 2 diabetes

Veech RL. The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism.

Peer-reviewed papers from Virta health on ketogenic diet and type 2 diabetes reversal

The Women’s Health Blog Series

Welcome to the second installment of the ‘blog post series’. Whether you are a new subscriber or just happened to stumble on this site through a google search or a referral, the blog post series is a collation of  3-4 prior posts that not only have a common theme but also provide the reader with some very important information.  

I have found this to be quite useful when I have to refer clients or people asking me questions about common topics.

Blog post 1

It is not uncommon after the age of 50 to develop a low acting thyroid. At times some of the symptoms a woman may be experiencing may be easily confused with menopausal symptoms and rightfully so. In this blog post, I provide you with information in an easy to understand format about the symptoms of thyroid disease What every woman needs to know about thyroid disease.

Blog post 2

Currently, the leading cause of liver failure and the need for liver transplant is not alcohol abuse, but a condition called non-alcoholic fatty liver disease (NAFLD). This article highlights what you need to know about NAFLD including common things that can place you at risk of developing this condition. I highly recommend that if you have ever been informed in the past by a healthcare provider that you have ‘fat in your liver’ that you take this information very seriously.

Blog post 3

We speak figuratively of how something broke our heart. But do you know that stress can literally lead to a form of heart failure and that women are at an increased risk? This article in the series highlights the impact of stress on a woman’s heart.

Blog post 4

One of the leading causes of infertility in women is polycystic ovarian syndrome (PCOS). It is closely linked to metabolic syndrome. By working closely with a functional healthcare provider, this condition is reversible.

I trust that this will provide a useful resource to reference articles on this blog.

As always I welcome your comments, questions or suggestions.

To your health and wellbeing,

How to tell the difference between type 1 and type 2 diabetes in adults

A lot of times, I come across patients who have to use insulin and aren’t quite sure whether they have Type 1 or type 2 diabetes.

I hope to be able to clarify the difference between the two, especially in an adult.

Type 1 diabetes

Type 1 diabetes is commonly called ‘juvenile onset diabetes.’ Type 1 diabetes is usually diagnosed in young children, often under the age of 5 years. Type 1 diabetes is an auto-immune disease. An auto-immune disease is when the body forms antibodies against itself.

In the case of type 1 diabetes, the body develops antibodies against the cells in the pancreas responsible for producing insulin. These are called the beta cells. When the beta cells are attacked and destroyed, the result is a rise in blood sugars. Someone with type 1 diabetes requires insulin.

During community talks as well and media appearances, I take the time to emphasize the difference between type 1 and type 2 diabetes.

It is fairly common for people to flippantly state that “Diabetes is a disease of lifestyle” without differentiating between the two.

Type 1 diabetes is not a disease of lifestyle.

Type 2 diabetes

Type 2 diabetes is different. It is not caused by a lack of insulin; instead, it is caused by a condition called insulin resistance. With insulin resistance, the cells of the body do not respond to insulin efficiently. In my book, I compare insulin resistance to the landlord changing the locks on the door to your apartment so that the key no longer works. The beta cells have to put out more insulin to overcome the resistant cells.

When someone with type 2 diabetes starts using insulin, does that mean they now have type 1 diabetes?

No. It is possible that with the ‘natural progression’ of type 2 diabetes, some people may need to start using insulin. They may also have a condition called late auto-immune diabetes of adulthood (LADA).

Individuals with LADA have a slower progression toward needing insulin than someone with type 1 diabetes.

There are also other scenarios where someone newly diagnosed with type 2 diabetes needs to be started on insulin right away. This still does not make them a type 1 diabetic.

What can happen with type 2 diabetes is that with time, the beta cells (the cells that produce insulin in the pancreas) may begin to degenerate and so cannot keep up with the production of insulin. It may be necessary to start insulin to keep blood glucose levels within the normal range and reduce the complications of diabetes.

How can you tell the difference between LADA, and Type 2 diabetes?

There are several blood tests that your healthcare provider can perform to help tell the difference between LADA and type 2 diabetes. This is particularly important as the treatments are different.

So it’s important to be pro-active when it comes to your overall health and wellbeing. Do not be afraid to ask questions.

I’ll be sharing more details in my upcoming online course, “What your doctor does not tell you about type 2 diabetes’. For more information about Type 2 diabetes, you can download a free copy of the first three chapters of my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes”, by clicking here.

To your health and wellbeing,

The power coaching when it comes to reaching your goals

Courtesy of Issac Smith on Unsplash.com

Finally, it looks like winter 2018 is finally behind us. For those of us in the Midwest, we had one last ‘winter storm’ this past Sunday. Hello Spring! With that in mind, we’re at the end of the first quarter of the year. If you are like most people, perhaps at the beginning of the year, you set some New Year resolutions. Yet we know that by the beginning of Spring, more than 70% of resolutions have been broken.

Springtime is the perfect time to take stock of what you have achieved thus far this year.

First of all, it is never too late to press the reset button and revisit your resolutions. That’s because the word “resolution” goes way beyond just New Year.

I looked up the dictionary definition of resolution. It says ‘a firm decision to do or not to do something.’

Let’s take a look at the first part of that statement- a firm decision.

When you’ve made a resolution in the past, be it a New Year resolution or not, was it really a firm decision? Or just on a whim at the end of the year holiday office party? Perhaps you said it because you believed it at the time.

If making a New Year resolution is indeed a firm decision for most people, then why do 70% of resolutions fail by the beginning of spring?

Why do we have such poor results if we are really trying to to make lasting change in our lives?

Do we like to see ourselves fail? Or do we keep making resolutions because somehow we feel inside ourselves that we are destined to succeed?

Having trained as a professional life coach, I believe in the possibility for all people.

I think that we make resolutions because we are drawn to want more in our lives. We are intrinsically wired to be creative

I also feel that that perhaps we need a different set of tools to create those results we say we want in our lives.

Setting Goals as a Tool:

One of the more important coaching tools is the SMART system.

One of the empowering tools when it comes to achieving results is the way we set goals.

A SMART goal is an acronym that stands for

• Specific
• Measurable
• Achievable
• Results in
• Time

You’ve probably heard this before. So let’s say your goal is to do a 5K walk/run this year. You’ve not even gotten off your couch but you feel you want to set this goal.

And now you want to use the SMART goal system to gauge the likelihood that you will succeed.

Here’s an example of what a SMART weight loss goal would look like:

Is your goal to walk a 5K (3.1 miles) specific? –yes it’s precisely 3.1 miles or a 5K

Is your goal to walk a 5K (3.1 miles) measurable?- yes the course will be outlined with distance markers

Is your goal to walk a 5K (3.1 miles) achievable?– yes thousands of people have achieved this goal before, so can you.

When you walk 5K (3.1 miles) will you see the results?- yes, you will gain results from the moment you start training until you cross the finish line at the race.

Do you have a set time to achieve these results?– yes you can choose to run/walk this race in the fall which gives you plenty of time to train.

Write down your goals

Let’s get back to goal setting as part of making a firm decision to do something. You now know to make sure that you have a SMART goal.

The next step is to write down your goals.

More than 80% of people who write down their goals succeed at them.

Commit to having your goals in a visible place and reading them every day. In fact, Napoleon Hill in his famous book, ‘Think and Grow Rich’ wrote about reading your goals out aloud to yourself twice a day- once in the morning and once at night.

Remember that goal setting goes beyond the intellectual exercise. You are priming your subconscious mind to work with you when reading out a goal.

If you want to get a different result, then get an accountability partner.

Another reason people fail at their resolutions is that they do not hold themselves accountable. Change is not easy. A lot of times we need to have an accountability partner to help us keep going along the path of transformation.

That’s precisely why when we make those resolutions, and when the rubber hits the road, we falter and find a reason why we really can’t reach those goals.

Then you become discouraged or even doubt why you made that decision in the first place. Perhaps you’ve been trying to lose weight like I have and the scale just doesn’t seem to be tipping in the right direction or as fast as you want it to. 🙁

This is when you need an impartial accountability partner, such as a coach. A coach is someone who can call you on your stuff and who is not biased. They have no agenda. An accountability partner or a coach should be willing to be that stand for you in those times when you say to yourself perhaps this was not such a great idea after all. That’s the power of a coach.

It’s often said that if you are up to great things in your life, then you need a life coach.

I agree with that. Not merely because I am also trained as a life coach, but because I see the power that coaching has to create a change by empowering people to see much more than what they see for themselves.

So as we embrace the upcoming warmer months of Spring into summer, here are some questions that I have for you:

• Are you tired of doing the same things over and over again and expecting a different result?
• When it comes to your health and overall wellbeing are you up to making 2019 a breakthrough year for you?
• Would you like to play a different game than just making a New Year resolution?
• If you knew you could not fail what dream goal would you like to see manifest in the next 12 months?

Now you may be wondering what all this has to do with managing type 2 diabetes or any other chronic illness. We are inundated with an internet that provides us with tons of information at the ‘click of a mouse.’

If it’s just having access to knowledge, then we should be able to achieve the results we say we want very quickly right? Wrong.

If we do not become aware of how our habits may sabotage us, or the thought patterns that hold us, hostage, we will never produce the results we say we want.

This is one of the reasons why I found coaching to be so transformational and why I am passionate about the power of coaching when it comes to helping clients and patients develop tools which will allow them to make permanent changes.

For a limited time only, I am offering a free 20-minute discovery session. I’d love to hear what you’re up to this year. Just send me an email at info@doctoreno.com to check in and let me know what you are up to. If you would like to schedule an appointment simply let me know and a member of my team will get back to you with my availability.

Until next time

To your Health & Wellbeing

How I used the stages of change to overhaul my pantry

Photo credit: Ross Findon on Unsplash

Perhaps there are people out there who can relate to this statement. There are some projects that we know we should do, but we keep putting off. This could go on for years…..

Intuitively, we know we’ll be better if we finally get to them. But the thought of going through the process of change just seem overwhelming and even painful. Eventually, we place these projects on the backburner for what may look like forever. In coaching, we refer to this attitude as tolerations.

And then finally something shifts inside of you and suddenly you’re ready to get into action.

Well, that happened to me a couple of weeks ago with my pantry. My pantry is a super-small room right off my kitchen. Over the years I’ve gotten into the bad habit of just stacking stuff one on top of the other in what later became an “orderly mess”.

My pantry had become a “painful toleration”.

I finally decided the toleration of accepting a cluttered and nonfunctional pantry was far worse than the liberation of creating some order in it.

I like the famous quote by Anais Nin:
“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.

But something had to change within me in order to change my relationship to my pantry.

Whether you need to overhaul your pantry because it’s cluttered like mine, or you want to make healthier lifestyle choices, I came up with six steps to overhaul your pantry in under an hour.

Step 1

The first step is your mindset. Be resolute. You are committed to doing this. You are ready to get into action. Put your game face on and “Just Do It” attitude.

Step 2
Go through your pantry and throw out every food item that has expired.

Step 3
Next, if there are any packages or cans that you may have purchased some time back, you know you’re not going ever to use them. They are not expired. Place these items lovingly in a paper bag to donate to a nearby food pantry.

Step 4

Next, take everything else remaining off the shelves. You can stack them on the kitchen table. Take the opportunity to clean the shelves. Seems pretty basic but I found that de-cluttering the shelves had such a therapeutic feel to it. You may see that there are some more items that you are willing to let go off. Place them in the bag to donate to a food pantry.

Step 5

If you have only shelving in your pantry, then you may want to buy some clear storage bins for this part. I did. Next, organize food items in common groupings. For instance, all the grains in one container or two, broths and soups in another, cans in another bin. If at all possible create a flow to your pantry, where the items that you commonly use, are more accessible than items you don’t use all the time.

Step 6

Finish off by stacking items like bottles and storage containers or other sundry items in a separate space, say in the under shelves.

There you have it, a de-cluttered pantry in under an hour!

I can’t begin to tell you what a rewarding feeling it is to have this new relationship with my pantry.

Here are some of the benefits of having an organized pantry:
• I know where everything is a vast time-savings
• I’ve challenged myself to cook with the supplies I already have in my pantry before I go out and buy new groceries. That simple step saves on my grocery bill.
• Also, this process allowed me to get rid of some of the foods I had long taken out of my diet such as pasta and white rice.

I humorously used the example of my pantry project to highlight our relationship to change. Whether it’s a new diet or exercise program, we tend to want to jump straight into action without first finding out what stage we are in.

There are several stages to change. Let me illustrate the stages of change using my pantry project:

• Pre-contemplation– clearing out the pantry? Not even on my mind!
Contemplation– Maybe someday in the distant future (when I retire) I may declutter that pantry.
Preparation– Hhmmm… This pantry is becoming a nuisance. Good idea to gather information about how much time it’s going to take me to clean it out.
Action– I’m done with the status quo. I’m ready to make some changes. I’m prepared to clean out the pantry! Let’s do this!
Maintenance– Now the challenge is maintaining the new habit of keeping everything in its place.
Relapse– This is the stage old habits that die hard may creep up on us like a Ninja warrior! Be prepared. I know there may be some days that I’m exhausted after a long day and I may come home and just throw things on the shelf resolving to ‘tidy up later.’ I know this, and so I have my systems in place if that should happen. Simply resolve to go back to place the stuff in the grouping system I have already created.
Termination– This is the final stage of change. I’m a pro at handling my well-organized pantry!

Here are some action steps I invite you to take

  • Spend the next week or so writing out a list of your tolerations. This could be projects you haven’t gotten to. It could be you’re living with a chronic illness but you’ve put your health on the back burner.
  • Next, review the stages of change and identify exactly where you are with each toleration.
  • Then, see if you can move one or two items on your toleration list from say the ‘pre-contemplation’ or ‘contemplation’ phase to the preparation stage and even action.

I would love to hear your feedback.

To your health and wellbeing

Which is Better- Exercise or Movement?

Photo Credit Luis Quintero on Unsplash

Spring is finally upon us. For those of us in the northern hemisphere I must say we had quite a challenging winter 2018. What with the polar vortex and all. Even my dogs didn’t look forward to going on their daily walks on those cold days.

As the temperatures get warmer and the days get longer there is a tendency for us to want to spend more time outdoors.  Some of us may have packed on a couple of “winter pounds” for a myriad of reasons- less activity, more comfort food, being in “hibernation mode” (I know I have :).

And there belies the question- which is better for you- Exercise? Or movement?

Caution: Before starting an exercise program, please consult your healthcare provider to ensure that you are safe to start a moderate intensity exercise program.

There is a myriad of benefits to exercise. For some of its benefits, check out a post I wrote here.

There are four types of exercise.

  • Aerobic (cardiovascular exercise)
  • Resistance (strength training) exercise
  • Flexibility
  • Balance

The American College of Sports Medicine recommends that a well-balanced exercise program consists of all four types.

The US Surgeon general, recommends in order to improve our health and wellbeing that we need to exercise at least 150 minutes of moderate intensity, or 75 minutes of intense activity every week.

As I type these numbers, it doesn’t seem to be a whole lot of time.  And yet it almost seems hard for us to squeeze in that 75-150 minutes a week.  I mean I know that I come up with reasons sometimes that I’m not able to set aside time to exercise 30 minutes 5 times a week.  According to the CDC only 23.5% of adult Americans perform aerobic and strength training weekly.

Research shows that being sedentary

A sedentary lifestyle is if you are not participating in at least 30 minutes of moderate activity at least 3 days a week for at least 3 months.

Having said all that, do you know that between 6-8 hours is spent in sedentary behavior.  I happen to wear a fitness device called an oura ring, and it sends me an alert every hour advising me to get up and stretch.

You may be someone that goes to the gym, does a daily run, etc., but how much activity you spend doing the rest of your day is also important. 

I find it very intriguing that even though I may have gotten in a workout on my peloton bike, at the end of the day the activity score shown on my oura ring is pretty low if I do not keep moving throughout the day.

So now you can see that even if you are someone who exercises regularly, that you could still fit into the “sedentary behavior” basket.

You may have heard the saying “sitting is the new smoking”? Well, that is because sitting time increases our all-cause mortality.

Now let me be honest, if you are that person who is the true definition of sedentary for whatever reason, I do not expect to get you to jump off the couch and go follow the surgeon general’s recommendations. I know this because, throughout my clinical career, I have actually had patients that

So there comes the concept of movement. Movement is merely the act of moving our bodies.  

There is a concept called nonexercise activity thermogenesis (NEAT). It is the energy we expend performing activities that are not sleeping, sitting or related to exercise. When we increase NEAT we can improve our overall exercise expenditure.

So how can we improve NEAT? By increasing everyday movement.

So here are some suggestions to increase movement throughout your day:

  • Set a reminder to take a 2-3 minute walk every hour.
  • Get a dog and walk it every day. 🙂
  • If you work in an office, work toward spending at least half of your office time standing, moving or doing light intense activities such as stretching, chair dips, lunges, etc.
  • Ditch the remote control and get up to manually change the TV/cable channel.
  • Purchase a fitness tracker and work up to and beyond 10,000 steps a day
  • If you are sedentary for whatever reason, perform exercises such as leg lifts, arm circles, biceps curls.
  • If you have to drive, park further and walk.
  • Climb the stairs instead of taking the elevator.
  • In between commercials on TV stretch, do some jumping jacks, chair dips, lunges, wall pushups, etc.
  • If you take your child to their after-school activity, take that time to do some movement yourself rather than sitting around watching your child. 😉

In summary, both increasing physical activity, as well as movement which improves NEAT, are equally important. None should be done to the exclusion of the other.

Until next time,

To your Health & Wellbeing,

What do you think?

When you hear the word “exercise” what does that bring up in you? What are some ways that you can think of to increase your physical activity?

I would love to hear your comments. Send me an email at info@doctoreno.com

Some of The Myriad Benefits of Exercise

Photo credit: Luis Quintero on Unsplash
  1. Improves energy
  2. Improves memory
  3. Improves the mood
  4. Decreases depression
  5. Decreases anxiety
  6. Reduces stress
  7. Increases muscle mass
  8. Creates a sense of calm
  9. Improves psychological wellbeing
  10. Builds mental resilience
  11. Helps with healthy aging
  12. Improves vitality
  13. Improves sexual health
  14. Improves respiratory function
  15. Strengthens the heart
  16. Helps build stronger bones
  17. Improves sleep
  18. Decreases fatigue
  19. Reduces joint pain
  20. Improves flexibility
  21. Improves balance
  22. Helps reverse diabetes type 2
  23. Helps with blood sugar control
  24. Decreases blood pressure 
  25. Improves the Mitochondrial function
  26. Improves immune function
  27. Decreases inflammation
  28. Promotes mindfulness
  29. Improves mind-body connection
  30. Improves bowel function
  31. Helps to reduce cognitive decline
  32. Promotes being part of a team
  33. Helps to connect with nature
  34. Improves body image
  35. Changes body composition
  36. Reduces body fat
  37. Helps maintain a healthy BMI
  38. Decreases resting heart rate
  39. Improves heart rate variability
  40. Decreases LDL cholesterol and increases HDL cholesterol
  41. Decreases total cholesterol and decreases triglycerides
  42. Improves the gut microbiome
  43. Decreases levels of estradiol
  44. Increases nitric oxide levels
  45. Improves metabolic health

How my story has been stopping me from making a career transition

It’s an exciting time in my life right now. I hope that by sharing my experience, it will help someone else in their life journey.

I’ve been working hard behind the scenes with my virtual manager and business coach putting together my first online summit featuring over twenty speakers scheduled to launch this May. I’m really excited, but the truth is reaching this point has taken me a long, long time.

You see, for the last ten years, I have been in the ‘planning to execute‘ phase. Due to my passion for promoting wellness I have wanted to transition from clinical medicine.

I trained as a professional coach in 2010, continued to attend course after course and hired coach after coach and was growing increasingly frustrated. Life kept getting in the way, and I kept telling myself I wasn’t quite ready.

When I came across functional medicine a year ago, I was exhilarated. I dove straight into the training modules. Finally, I had found my tribe! Now I felt armed with the tools to make the transition a reality.

My mission is to create a global wellness platform that provides women over 50 with tools to optimize their health and wellbeing so they can thrive into their golden years.

I’m being vulnerable in sharing my vision this way because even though I feel strongly about it and recognize the need for this kind of information in this particular demographic, I have dealt with a lot of self-doubts. In fact, at times, I wanted to quit.

You see I have been deeply attached to ‘my story.’ And I am still working through it.

Some time back, I wrote a post about how our stories prevent us from reaching our full potential . You see we all have a story we tell ourselves.

A story is a tale that you repeat over and over again. In the beginning, the story may have been told to you by someone in authority. It may have been your parent(s), a teacher, a pastor.

That ‘someone’ initially shared this story with you. And you believed it. It becomes the lens through which you see your life. Then it became your perception of your reality. It does not have to be “a bad story.” The more you hear the story, the more significant potential it has to limit how you see yourself and potential.

Let me share “my story” again and how up till now as a woman in her fifties, it has continued to stop me:

I was born a premature baby in London, UK. My mother was getting very ill, and so when she went into pre-term labor, the goal was to save her with no thought about her baby. In the 1960s the odds of a premature birth under or close to 7 months surviving were a lot less than they are now. My mother who was a nurse at the time promised herself that if I survived, I would become a doctor to ‘give back.’ and so that was the story that was told to me from the time I was a little girl.

Since I graduated from medical school in 1987, I have enjoyed a successful medical career. However, over the span of my career, I am keenly aware of the impact lifestyle choices have on overall health.

As time went on, I became more passionate about focusing on disease prevention and wellness.

About 10 years ago, I was introduced to the field of professional life coaching. It lit me up. And so I trained as a professional coach. I felt that coaching was a model that could help people deal with their mindset and empower them to make healthy lifestyle choices. I also spoke at some community events and saw the impact my words had on my audience.

I also went on to write an award-winning book for people living with type 2 diabetes.

However, I let my story prevent me from transitioning into a career as a full-time speaker, consultant, and coach.

So my work, is to own the story I tell myself and recognize where it stops me.

It is essential to take responsibility for the track it is playing in your mind over and over again.

So here are some of the steps you can take to notice where your story shows up:

  • Notice where you are telling a story. For instance, when you find yourself justifying why you can’t meet a goal.
  • Notice where you tell stories about other people or other situations or circumstances.
  • Take small steps to start to dismantle your story. You can start by taking the time to craft an empowering story.

For instance, yes, it is possible for me to transition to a career as a functional medicine consultant.

So here is the story that I am committed to telling myself moving forward:

  • I am a transformative force for G(o)od
  • If not me, whom?
  • If not now, when?

I’d love to hear your comments and feedback on how your story may have been running your life.

If you would like a FREE download of the first three chapters of my book, click here.

To your Health & Wellbeing,


Five Strategies to help you reach healthy blood sugar control in the New Year

Happy 2019! I trust you are off to a great start. It is great to be back to blogging after such a long time. As I shared in an earlier newsletter, late summer we had some challenges upgrading the platform and then as the holidays approached, I had a rather grueling work schedule, in addition to a brief media blitz in Wisconsin. I am currently writing to you whilst on a much-needed vacation in Nigeria.

This is a re-purposed article from an older blog article. I like to start the new year highlighting New Year resolutions.

Now that we are in a New Year, we can press the reset button and set some New Year resolutions to reach your healthy blood sugar goals.

What is a resolution?

A resolution is a firm decision to do or not to do something. Research has shown that close to 90% of resolutions fail by the end of the first quarter of the year.

If you are committed to thriving with type 2 diabetes, then consider developing an empowered relationship to resolutions. Remember you are not just a person living with type 2 diabetes.

Here are Five New Year Resolutions to start with:

It all begins with the ABCs

In my award-winning book, “Dr. Eno’s A-to-Z Guide to thriving with Type 2 Diabetes”, the first three chapters focused on what I started calling the ABCs. The ABCs is an acronym which stands for A-Acceptance, B-Belief and C-Commitment to change.

No matter what challenges you may be dealing with, whether it is learning to live with a chronic illness such as type 2 diabetes, or simply deciding to make a new year resolution it all begins with your ABCs.

The reason many New Year resolutions fail, is because we tend to avoid change by making excuses. First is the need to accept some things need to change. Next is developing a belief that you can make changes. The final step is making a commitment to improve. To download a free e-book of the first three chapters of my book, click here.

Learn all there is to learn about type 2 diabetes

I continue to emphasize that knowledge is the first step toward personal empowerment. The field of diabetes care is rapidly changing. Become curious about the latest information particularly as it may pertain to diabetes care. Search for reputable sources of information.

If you find a treatment option that you feel may work for you, then be sure to have a discussion with your healthcare provider about this. Remember that there are several ways to treat diabetes, however, making changes to your lifestyle is the foundation for reaching healthy blood sugars. So this year, make a commitment to taking stock of your current lifestyle. Look for ways that you can make some changes. Always remember to start with small changes and then build on them. With time small changes can create significant shifts in your overall health and wellness.

Do what it takes this year to achieve and maintain healthy blood sugars. There may be times when your blood sugars get out of control. This can be very discouraging. At times some people living diabetes may become discouraged and resigned. The thing to keep in mind is that uncontrolled blood sugars are associated with a higher risk of complications. So if you commit to doing whatever it takes to achieve and maintain healthy blood sugars, you will reduce the risk of complications. It may mean, increasing the amount of physical activity, watching portion sizes a lot more closely, and cutting out the excuses.

See your healthcare provider on a regular basis.

Early in the year is an excellent time to look at your calendar and schedule visits with your healthcare provider as well as any specialists on a regular basis are vital in helping to detect any early complications. Not only should you see your healthcare provider on a regular basis, but also I suggest that you even know what kinds of testing you need to have done. For instance every three months, you should have an A1C performed. This test allows your healthcare provider as well as you to know how well controlled your blood sugars have been. For tips on how to choose a healthcare provider

Know your “ABC numbers.”

The ABCs stand for another acronym. It is essential to know your ABC numbers. This means- A1C, Blood sugars and cholesterol. Have a discussion with your healthcare provider about what your target ranges are.

Your numbers are based on guidelines recommended by the American Diabetes Association:

  • A1C <7.0 %
  • Blood sugars (fasting) 80-120 mg/dl
  • Cholesterol- LDL (think bad lousy cholesterol) less than 100 mg/dl; HDL (think good happy cholesterol) more than 60 mg/dl.

Keep up with routine health exams.

Once a year schedule an annual physical exam, as well as routine screening tests. Do not leave these to chance. This is because type 2 diabetes increases your risk of some other diseases such as heart disease as well as strokes as well as certain cancers.

I suggest marking this on your calendar early in the year. Perhaps you may want to pick your birthday month, for instance, to get all your routine medical exams done.

So there you have it. Five New Year resolutions to get the year off to a robust start in achieving healthy blood sugars.

My New Year resolution is to create more consistent content for this platform as well as online and in-person programs that can help you reach your goals of thriving by helping you to improve your metabolic health.

So let’s get started! Click here to download the free e-book of the first three chapters of my book. And if you would like to purchase a copy of my book, click here.


To your Health & Wellbeing,

Health Awareness Topic- Women and Mental Health

 

 

 

This month is Mental Health Awareness month. According to the National Institute of Mental Health, there are 1 in 6 Americans (44 million Americans over the age of 18 years)  living with a mental illness. Mental illness covers a broad spectrum ranging from mild to severe and tends to affect women more than men. Depression is the most common mental illness. Women are more likely to be diagnosed with depression than men.

There are certain kinds of depression unique to women. These include premenstrual dysphoric disorder (commonly known as PMS), perinatal depression (widely known as postpartum depression) and perimenopausal depression.

Living with a chronic illness such as type 2 diabetes can be very overwhelming, and some people may experience depressive symptoms but do not have significant clinical depression.

Examples of depressive symptoms

-feelings of sadness or overwhelm nearly every day
-thoughts of worthlessness almost every day
-lack of motivation or feeling agitated almost every day
-loss of interest in everyday activities almost every day
-the inability of sleep or excessive sleep almost every day
-loss of appetite and/or a significant change in weight
-decreased ability to concentrate
-thoughts of harming oneself such as suicide

So how do you know if you are just having depressive symptoms or if you have a diagnosis of major depression?  Depressive symptoms do not last a long time. A person with major depression experiences at least three of the symptoms listed plus feeling depressed on and off for a prolonged period up- to two years.

What to do if you feel you have a mental illness

If you or someone you know is facing a mental illness, please seek help immediately. Not all depression is mental illness, and not all mental illness is depression.
There are some medical conditions especially in women that may cause a change in the mood and appear to be depression.

Some examples:
Thyroid disorder particularly hypothyroidism
-hormonal imbalances such as menopause
-food intolerances such as gluten sensitivity
-disrupted sleep patterns in conditions like sleep apnea
-vitamin B12 and/or folate deficiency
-low blood count (anemia)

Your healthcare provider may perform some blood-work to make sure you do not have a treatable medical condition.
If treatable medical conditions have been ruled out, then your healthcare provider most likely will recommend you to a mental health specialist.

Treating Mental illness

When it comes to treating mental illness, there are several options. It depends on the nature of the mental illness. Seeking treatment with a licensed mental healthcare professional is essential.  ‘Talk therapy’ may be a starting point. There are many types of talk therapy such as counseling, psychotherapy, or cognitive behavioral therapy. But some types of mental illness such as bipolar disorder, schizophrenia or severe depression may also require the use of medications right from the start.

Nutrition is also important. Pay attention to what you are eating. Eat a well-balanced diet rich in whole foods which contain a healthy ratio of proteins, carbohydrates, and fats, as well as phytonutrients (plant sourced micronutrients).

Suicide risk and mental illness

Mental health illness triggers a lot of stigmas. People with mental health issues may go through a lot of emotional pain and feel isolated. They may be afraid to seek help. Some people dealing with a mental illness may begin to have suicidal thoughts or even resort to suicide.

According to the US Department of Health and Human Services, 90% of people who commit suicide have a mental illness such as depression, bipolar disorder, schizophrenia or alcoholism. Most people who commit suicide may have attempted suicide in the past. They may do so because they want the physical and emotional pain they have been going through to stop and ending their lives may seem to be the only resort.

In summary, it is essential that as women we pay particular attention to our mental health as well as that of our loved ones. If you or someone you love is living with an untreated mental illness, please get help immediately. It is possible to prevent suicide Suicide is preventable with the right intervention.

Some mental health resources:

Depression in women- Five things you should know

National suicide prevention line

Department of Health and Human Services

 

To your health and wellbeing,

Using the internet for online medical advice

 

 

 

 

 

People turn to the internet for online medical advice for a variety of reasons. Some people to help them try to diagnose an illness. Others to get a better understanding of health and wellness issues to improve the quality of their lives.

Numerous websites provide medical information. Some of the well known reputable websites include  WebMD,  the Mayo Clinic, Cleveland Clinic. You can learn a lot on topics such as nutrition, exercise, common symptoms of diseases, drugs, holistic medicine to name a few.

There are more and more independent doctors and health care experts- such as myself- who share their expertise in a particular area such as type 2 diabetes or other chronic illnesses. This is called information marketing and is geared toward empowering people to make healthier lifestyle choices as well as directing people to a healthcare professional who may be able to help with their medical issues.

I love the fact that as healthcare providers and experts in our various fields, we can provide all this information on this global platform.   It is clear based on internet searches that people want this knowledge.

There are also a lot of not so reputable health information websites. Some of the information that may be downright wrong or misleading.

Because of this, it is crucial to verify the credentials of the source you are getting your information. One of the ways you can do this is, to find out if a healthcare professional who is board-certified wrote the info on the website.

A board-certified physician has completed a residency program in their chosen specialty and also has gone a step further to pass a standardized examination. Depending on the specialty, board-certified physicians are required to undergo  ‘continuing medical education’ (CME). Most insurance providers and also hospitals mandate that a physician is board certified. To confirm whether your healthcare provider is board certified click here.

 

Cyberchondria – the danger of online medical advice

A lot of people search the internet for the answers to common health concerns. It is not unusual for patients to come to see their healthcare provider, armed with information from a web search. I experience patients referring to the results of their internet searches on a reasonably regular basis.

There are some dangers with seeking online medical advice. The most common is getting wrong information. Some websites show up high on search engines, but they provide the worse case scenarios. You could be getting the wrong advice–with severe consequences.

Some people become so obsessed with the advice they get on the internet. They may continuously feel that something terrible is happening to them. They are always thinking the worst and use the internet to validate this feeling.

This constant obsession with the ‘worst-case scenario’ for what may be standard medical conditions is called cyberchondria. Cyberchondria can become very serious and disabling. Someone suffering from cyberchondria may not even realize how this is affecting their ability to function.

Cyberchondriacs spend a lot of time and resources going back and forth to see their healthcare provider armed with their latest findings from their internet research. They may end up demanding medical tests and procedures. And they may move from one healthcare provider to another if they do not get the answers to validate how sick they feel.

How to deal with cyberchondria

So let’s say you are that person (or you know a person 🙂 I’ve described in this article, what can you do? Just like a hypochondriac, cyberchondriacs believe that what they are suffering from is real. Dismissing someone with cyberchondria and telling them it’s “all in their head” is not going to work. In fact, it may cause them to isolate themselves and not open up to their loved ones or worse still their healthcare providers.

The best advice I can give anyone obsessed with continually searching the internet for medical illness is to stop searching the web. Just as I would advise an alcoholic not to just ‘drink a little.’  Take an internet and social media holiday.

The next step is to seek the advice of a competent and compassionate therapist. Talk therapy can be very therapeutic. It can help to ease the anxiety associated with cyberchondria. Talk therapy can also provide coping skills and tools.

In summary, the best approach to using the internet for online medical advice is to be curious yet cautious. Use reputable sites. Do not go to the Internet looking for worst-case scenarios. And finally, know when to stop and seek the timely help of a qualified healthcare professional.

To your health and wellbeing,

Health Awareness Topic- What every woman needs to know about fatty liver disease

 

 

 

 

 

 

It was a routine request for a preoperative consultation in the hospital.
I cheerfully introduced myself to my 33-year-old female patient. She had presented to the emergency room with upper abdominal pain. She had an ultrasound of her abdomen performed which revealed inflammation of her gallbladder. She was scheduled to have surgery the following day.

I briefly read the ultrasound report I noticed an additional abnormality. I asked her to tell me about herself. She had a history of high blood pressure otherwise considered herself healthy. She did not drink alcohol but consumed several cans of soda a day. She had a twin sister recently diagnosed with type 2 diabetes. Her mother who was present in the room, also had type 2 diabetes. It seemed to be coming together in my mind.

I assured her that I thought she would do well with the surgery, however, that I had found a slight concern on the ultrasound. The ultrasound showed that she had fat in her liver. I explained to her what this meant and some of the things in her history that had put her at risk for this happening. I shared with her that because she was obese with a history of high blood pressure as well as having a family history type 2 diabetes mellitus she was at increased risk of developing type 2 diabetes herself.

So what is fatty liver disease?

My patient had is a condition called non-alcoholic fatty liver disease, commonly called fatty liver disease. Fatty liver disease is becoming more common with some studies showing that up it affects up to 46% of adult Americans. It is more common in women. It usually develops between 40 and 50 years of age, although there are some young people in their teens being diagnosed with fatty liver disease. Many people do not know that they have fatty liver disease. Up to 2-3% of people have a more condition called nonalcoholic steatohepatitis (NASH). NASH can progress to advanced liver disease called cirrhosis.

Some Conditions associated with fatty liver disease

  • Obesity– more than 70% of people with fatty liver disease are obese. Of more concern is abdominal obesity. The waist circumference is a measure of fat in the abdominal cavity. Measuring the waist circumference helps to determine abdominal obesity. A waist circumference (over 31.5 inches in women and 37 inches in men). Fat can accumulate around organs as well as inside organs such as the liver. Fat cells produce harmful substances increase inflammation in the body and can lead to chronic illness. In the liver the fat cells can cause inflammation called nonalcoholic steatohepatitis (NASH) and can eventually lead to a condition called cirrhosis.
  • Type 2 diabetes – Up to 75% of people with fatty liver disease have type 2 diabetes
  • Metabolic syndrome– Metabolic syndrome is not a disease, but a collection of symptoms. Metabolic syndrome increases the risk for type 2 diabetes, hypertension and heart disease. Click here to read more about an article I wrote about metabolic syndrome and the link between type 2 diabetes and hypertension.
  • High triglycerides– Between 20-80% of people with fatty liver disease have high triglycerides.
  • Exposure to certain toxins and drugs– some medications that are used to treat medical conditions can cause fatty liver disease. These include steroids (prednisone and hydrocortisone, methyl prednisolone) amiodarone, tamoxifen

What are the signs or symptoms of fatty liver disease?

Unfortunately most people with fatty liver disease do not have any symptoms. At other times a routine blood test performed by your healthcare provider might show abnormal liver enzymes which may be a clue that there may be some inflammation in the liver .

How do you to treat fatty liver disease?

The good news is that if addressed early, fatty liver disease is reversible. Here are some things you can do:

  • Weight loss- If you have been informed by your healthcare provider that you have fatty liver disease, please take this seriously. Lose weight. Lose weight gradually. Rapid weight loss has been found to worsen fatty liver disease. Do not just look at this as a ‘weight loss plan’, rather look at ways to improve your lifestyle. Work with your healthcare provider to create a lifestyle plan that works for you and allows you to thrive.
  • Eliminate high fructose corn syrup- High fructose corn syrup is a manufactured chemical sweeter that is present in a lot of foods. It is very common in soda as well as several other processed foods including salad dressing and even ketchup. There are some studies that show a relationship between high fructose corn syrup and liver disease.
  • Reduce processed foods. Increase fruits and vegetables- processed foods contain a lot of simple carbohydrates. These simple carbohydrates get turned into sugar. Excess sugar gets taken up into the liver and converted to fat. Reduce simple sugars and increase the amount of fruits and vegetables in your diet. This way you are getting more fiber, vitamins, minerals and powerful nutrients that have healing properties.
  • Treat diabetes – If you have been diagnosed with type 2 diabetes or borderline diabetes get this treated.

This is the time to focus on making healthy lifestyle changes. If left untreated, fatty liver disease could progress and cause severe damage to the liver. Be proactive. This is your life. I want to see more women thrive into their older years rather than suffer from the effects of chronic illness. If you would like more information about working with me click here.

To your health and wellbeing,

How stress can cause a ‘broken heart’

Hello there and welcome back,

February is heart disease awareness month. In my last article, I promised that I would share how stress can cause heart disease.

I recall the first time I met a patient diagnosed with this condition more than seven years ago:

She was close to 80 years old. She came in ‘feeling poorly’ for the last few months. Her husband had died from a chronic illness almost 15 years ago, and she never remarried. Despite being afflicted with constant back pain, she still tried to remain active. She attended regular outings of her red hat society and other senior activities. She was a delight to interview. I admitted her to the hospital, and we began running a battery of tests to find out what was the problem.

By the next day, her test results started to come in. Her heart enzyme levels were dangerously high. But she had never complained of chest pain to explain this. A cardiologist (a heart specialist) was asked to see her. She had a heart test called an echocardiogram. The results of the analysis showed that she had a heart condition called Takotsubo Cardiomyopathy.

OK before your eyes glaze over, I know this sounds like a mouthful. But let me gently break the news to you- it is also called ‘Broken Heart Syndrome.’ This particular heart condition could be caused by-you guessed right if you said STRESS!

It was first described in Japan and is more common amongst women. The kicker is that either intense emotional or physical stress causes it. Anything from a medical illness, to domestic abuse, heated arguments, devastating financial loss, the death of a close relative. The list goes on. The word ‘Takotsubo’ in Japanese means ‘octopus pot.’ It describes the unique way it causes the bottom part of the heart to balloon up.

It is not sure how precisely takotsubo cardiomyopathy damages the heart. It is thought to be related to the release of a significant amount of the stress hormone called epinephrine released into the bloodstream. Unlike the more common type of heart disease-coronary artery disease- that is caused by blockage of the arteries.

The use of over the counter cold medication called phenylephrine, as well as illicit drugs like methamphetamine and cocaine, can also cause takotsubo cardiomyopathy.

It can cause the same symptoms as a heart attack like chest pain. Some patients may have shortness of breath (like my patient) or have a fainting spell.

The good news is that takotsubo cardiomyopathy if discovered and treated early is reversible. The sad story is that if left untreated eventually the heart muscle becomes too weak and can eventually lead to heart failure. Unfortunately, this was the case for my lovely elderly patient.

I share this information with you because it became clear to me that just as stress is insidious in our lives, so can it’s effects be in our hearts.

Who would believe that a heart could break from our life experiences?

The truth is that there are far too many women out there just like my patient. They are going through life oblivious to the effects that stress has on them.

They are our sisters, our neighbors, mothers, co-workers, and yes- even ourselves.

How many times have you felt a twinge of chest pain and chalked it down to ‘just stress’? Now I’m not saying to you that every twinge that you feel is a heart attack about to happen. What I am saying is that as women we have been given an ‘innate knowingness’ about our bodies. It is called a woman’s intuition. It is that intuition that signals that heart pain (ache). Then we dismiss it as ‘only stress.’ It is our body’s inner knowingness signaling us to stop and pay attention, to search within.

I know from firsthand experience as a primary care provider that being diagnosed with a chronic illness such as type 2 diabetes adds another layer of stress. But I am also here to assure you it does not have to be this way.

I do not want to see one more woman suffer from a broken heart.

It is my vision to form a TRIBE of likeminded women who want to THRIVE and experience ‘stress less’ lives.

Here are some things you can start doing today:

  • Pay attention to the signals that your body sends to you. Be still, take notice, and check within.
  • If these symptoms persist, please schedule an appointment to see your healthcare provider.
  • If you are not satisfied with the answer that your healthcare provider gives you, please be persistent. Don’t get blown off.
  • Make it a priority to learn how to handle stress
  • If you are a woman living with chronic illness find ways to create a network that supports you.

As always I look forward to your comments.

To your Health and Wellbeing,

 

How This Simple Strategy is Helping Me Tiptoe Past Overwhelm

personal developmentRecently I’ve had a lot on my plate. Between going to several work locations as a travel physician, building my online wellness platform; working on marketing and publicity; preparing for the release of my upcoming book, plus training for a fall marathon, it’s little wonder I’m beginning to experience some overwhelm.

In an earlier article I wrote about a strategy to get past overwhelm and get back into action.

But when we try to get back into action, we tend to set big goals and we get overwhelmed again.

Let’s say your goal at the beginning of  the year was to be a svelte size 6 by the start of the summer season. But somewhere around February, you stopped exercising, stopped watching your diet. Now you are 10 lbs heavier than you were at the beginning of the year!

You’re wondering if it’s worth even trying to lose all that weight. Perhaps you’re feeling so defeated that you’ve decided you’ll wait until 2018 to set another new year resolution.

In my upcoming book, I write about ‘the stages of change’. Too often we go straight into action without too much preparation. And when we do get into action we tend to go all out. You know the slogan ‘Go BIG or go home!’  Then we find we’re having a hard time keeping up the momentum. Next we become overwhelmed!

What if there was a way to tiptoe past overwhelm so that we stay in action and on the road to producing the results we desire?

Well, there is a way, I’ve learned about. It is called the Kaizen method. It teaches how to take simple small steps. When starting out with the kaizen method, the steps are so ridiculously small, that it may seem impossible they could create longlasting change. That’s the beauty of the kaizen method. The steps seem so small initially that we may not even feel we are making any change. The key is to success in the kaizen method is to consistently build on these small steps.

You see when we set BIG goals, we trigger an alarm in an area of our brain called the amygdala.
The amygdala is part of our primitive brain and was developed in pre-historic times to protect us from harm. So if the primitive man ventured into unfamiliar surroundings, it was the amygdala that fired off alarm signals warning him to retreat back to familiar surroundings.

The amygdala fires off the same way when we venture into the unfamiliar territory of making changes. Even when we know those changes could make us healthier and happier.

No wonder we never quite seem able to sustain a weight loss goal, exercise regimen, better diabetes numbers etc. because to our brains these all represent change. And our amygdala thinks change could be bad.

By learning to take simple small steps, consistently, we can make the needed change and not alarm our amygdala!

So what could this look like?

Let’s go back to the weight loss goal example and see how we can apply the kaizen method.

Rather than focus on the short-term goal of weight loss, focus on the long-term benefits losing weight will give you.

If you are living with type 2 diabetes or borderline diabetes, perhaps you may focus on the fact that in the long-term, losing weight has been proven to help with better blood sugar control and in the case of borderline diabetes can possibly reverse it.

Think of something really small that you can start with. This is the time to get really creative. Then commit to taking a simple small step.

For instance if you want to start a walking program, don’t rush to the fitness store and spend hundreds of dollars getting geared up in the ‘latest and the greatest gadgetry’. Rather, start with something as small as walking in place at home or at work for 1 minute a day. Or maybe you want to cut down on your food intake. Rather than look for ways to immediately cut out 500 calories per day, as most nutritionists may recommend, start with simply leaving a spoonful of food on your plate.

As these simple actions become easy, add on to with more small steps. For instance walk in place for 2 minutes a day. Leave two spoonfuls on your plate.

Be consistent. Make it a habit. Celebrate your wins.

Using the kaizen method can create a snowball effect. You will notice yourself wanting to take on more as your newfound habit becomes fun.

Can you think of other aspects of your life that could benefit from using the kaizen method?

Too often we tend to focus on what needs to be fixed. This is a very narrow way of looking at our lives. Every aspect of our lives are interconnected. You spiritual health affects your emotional health as well as your physical health. How you eat, sense and feel, relate to others as well as your perception of the world affects your whole person, and ultimately your health.

Whether you are living with a chronic illness or just looking to be healthier, it is always best to take a whole person approach to wellness.  The kaizen method is just one way that allows us to focus on the small things that ultimately affect the whole.

In my upcoming coaching programs, I’ll be sharing several strategies that help to focus on the whole person when it comes to improving our overall health and wellbeing.

I’m also excited that the second edition of my book “Dr. Eno’s Guide to Living Powerfully with Type 2 Diabetes’ will soon be released.  If you would like to download a free copy of the ebook that highlights the first three chapters of my upcoming book, click here.

To your health and wellbeing,

May 2017 Awareness Topic: The Difference Between Overweight and Obesity

In the May 2017 Health Awareness Topic, I’ll discuss the difference between what it is to be obese and how this differs from being overweight. In my years of clinical practice, I have found that people do not like to describe themselves as obese. Somehow the word obese has become ‘politically incorrect’ and offensive. So people, even healthcare professionals, choose to use the word ‘overweight’ even when they really mean that a person is obese.

I recall once when I was educating a patient about the fact that her CT scan showed that she had fat in her liver and this put her at a higher risk of diabetes. She later reported me that I said she was fat!

My assertion is that if we continue to tiptoe around this issue and not address obesity for what it is we will never be able to take control of the rising obesity or type 2 diabetes and borderline diabetes epidemic. Our patients look to us to tell them the truth. Being told the truth does not have to be offensive, but it may require an uncomfortable conversation that more healthcare professionals need to get comfortable having.

The similar statistics between obesity and type 2 diabetes

If you look closely at the statistics that I started this article with you will notice that they are similar over 100 million of adult Americans are either obese or overweight. Over 100 million adult Americans have either type 2 or borderline diabetes

Body Mass Index- BMI

The body mass index (BMI) is used to define normal weight, underweight, overweight and obese conditions. For the most part, BMI correlates with the amount of fat a person has. So a higher BMI correlates with a higher risk for obesity. There are some exceptions to using the BMI exclusively. For instance a person who is muscular may have a high BMI but they are not obese.

The BMI is calculated by dividing the weight in kilograms by the height. There are many BMI calculators online. All you need to know is your height and your weight (in kilograms) and then you can plug those numbers in. For an example of a BMI calculator, click here.

Categories of BMI:

Underweight -BMI less than 18.5

Normal weight- BMI 18.5- 24.9

Overweight- BMI 25-29.9

Obesity class I 30-34.9

Obesity class II 35- 39.9

Obesity class III greater than 40

Over two-thirds of the adult population in America is either overweight or obese. Currently there are over 29 million Americans living with type 2 diabetes. There are an additional 86 million are living with borderline diabetes. The common denominator for both of these conditions is the rising obesity epidemic.

Consider this, if you have been diagnosed with borderline diabetes and commit to losing just 10% of your body weight, you can reduce your chance of developing type 2 diabetes.

The goal is to maintain a healthy and normal BMI of between 18.5 and 24.9

For people who are overweight or obese I usually get a lot of rebuttal telling me they have not had BMI in that range since they were in high school or middle school.

That’s OK. Just as it took some time to gain weight, it will also take some time to lose weight. So let’s start with that statement. You are OK.  Accept that you are overweight or obese. This statement should not be seen as  someone making a derogatory statement about you. It simply means that if you want to live a long and healthy life there is work to do. You are not alone in this obesity epidemic.  There are close to 200 million people in the United States alone. Start by developing a support system. Work closely with your healthcare professional.

Changing old habits is never easy. There are several stages to change. One thing you can start today is to start taking simple small steps every day. Taking simple small steps helps to reduce the sense of overwhelm that making big changes can cause. And because the changes seem so small in the beginning you are more likely to stick with them.

Here’s an example of a simple small step you can take on. Purchase a fitness tracker. What is the common step goal everyone says when you start counting steps? 10,000 steps! Look at that number, doesn’t ten thousand sound like a whole lot to start with? Consider this. Set a goal to walk 1000 steps on your first day. And then when you reach that goal (or exceed it) slowly increase your daily goal. Eventually you’ll reach your goal without feeling overwhelmed and along the way you’ll discover ways to increase the amount of steps you take every day.

It all starts with what I call the ABCs – Acceptance, Belief and Commitment.

For more information about the ABCs and how you can use these to start making changes in your life, you can download a free copy of the first three chapters of my upcoming book, ‘Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’ by clicking here.

To your health and wellbeing,

 

Seven Tips People Living With Diabetes Mellitus Type 2 Can Use to Make the Most of an Office Appointment with Their Healthcare Provider

Diabetes MellitusFor some people living with diabetes mellitus type 2, an appointment with their healthcare provider, particularly a doctor, can be overwhelming.

When I was in a primary care practice, I often told my patients that for the most part they had an average of four to six office appointments a year. The typical primary care visit is limited to only 15 minutes. So you need to prepare ahead of time to make the most of the appointment.
Here are seven tips you can use to make the most of your office appointment. If you use all these tips, you will get the most out of every visit to the doctor.

Tip Number 1: Take a Long Record of Your Blood Sugars

Make a habit of keeping a record of your blood sugars. Keep it simple. You do not need fancy computer software. All you need is a small notebook. You can get this at any office supply or drug store. Divide each page of the notebook into at least two columns.

The first column is for the date and time that you check your blood sugars. The second column is to a record of your blood sugar levels.

Some people do not like to prick their fingers to check their blood sugars. I’ve shared in an article some tips on how to check your sugars once a day. Over the period of a week you be able to trend of how your blood sugars are running.

By keeping a log of your blood sugars, it helps provide important feedback for you as well as your healthcare provider. For instance if your blood sugars suddenly begin to run high or low, you can pinpoint the exact time this happened. Perhaps you were sick, had started an exercise program or went on vacation and over-indulged in food. All this information can help you and your healthcare provider to make important decisions regarding your diabetes management.

Tip Number 2: Take Along Your Glucometer

When I was in an office based practice, I liked to look over the blood sugar readings on my patients’ glucometers. A number of the new generation glucometers provide a lot of valuable information. For instance some machines average the sugars over say a 14-30 day period. Others may average the blood sugars before and after meals. This is a great teaching tool for diabetic patients. It allows them to see how their blood sugars affects their overall health and wellbeing.

Tip Number 3: If Your appointment is First Thing in the Morning Do Not Eat Breakfast

Take advantage of an early morning appointment with your healthcare provider and arrive ‘fasting’. Nowadays, a lot of healthcare providers perform blood tests in their offices to check blood sugar, A1C and lipid profile. For more information on the importance of knowing your numbers, click here.

Tip Number 4: Always Carry a Snack

Has this ever happened to you? You are at the doctor’s office and the wait time is longer than you planned. But you had taken your medications earlier on in the day. Next you begin to experience the ‘bottoming out’ sensation as your sugars take a nose-dive.

Next thing you know it you’re being carted into a waiting ambulance to the emergency room!

I advise people living with diabetes to always carry around a piece of ‘hard candy’. I also recommend meal replacement bars such as glucerna. So always be sure to take a snack along with you wherever you go.

Tip Number 5: Keep a Journal and Take This Along to Your Visit

Living powerfully with diabetes requires that you do things a little differently than the crowd. Keeping a journal or a diary is one of those things. A lot of times, a journal is for your personal use. However at times it may help your healthcare provider to detect why your sugars may be running high or low.

There are several ways you can choose to journal. For instance, you can keep a food journal. If you keep a record of what you eat, you may notice there are certain foods that make your blood sugars go up.

This gives you a good idea of knowing what foods to reduce or what to take out of your diet completely.
You may find out that stress affects your blood sugars. Some people may prefer to journal and record their blood sugars in the same book. Decide what works for you and just do it.

Tip Number 6: Be Prepared to Take Off Your Shoes and Socks

Foot care is a very important aspect of diabetes care. Inspecting the feet helps to prevent or detect early foot infections, which could lead to other complications. I always insisted on looking at the feet of all my diabetic patients at least every 2-3 months.

It is also important to make sure that you have sensation on the bottom of your feet.

Your physician can perform a very simple test called a fine filament test on your feet. This is a simple instrument and as there name suggests a thin filament. If you do not feel the filament being pressed on the bottom of your feet, you may be developing a complication called diabetic neuropathy. This is when the nerves are damaged and you can no longer feel your feet. The danger is that you could step on a nail for instance and not know because you could not feel it.

Diabetic neuropathy is one of the leading causes of amputations in people living with diabetes mellitus. So make sure that your doctor performs this test on your feet every three months.

Tip Number 7: Be Prepared for Change

In diabetes type 2 is a disease that has the potential to change over time. Regimens that worked earlier on may not work so well as the disease advances. As time goes on it may get harder to control your blood sugars. So be prepared for change.

For example you may have been on a medication for a long time and your blood sugars had been well controlled. All of a sudden your blood sugars start running high. Your doctor may decide to add another medication or even insulin. Always believe that your healthcare provider has your best interest at heart.

I know that there are a lot of skeptics out there about the pharmaceutical industry. Research is being conducted to develop new drugs, which may help preserve the function of the pancreas.
To reduce the potential complications of type 2 diabetes follow your doctor’s advice. In the first three chapters of my upcoming book, “Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes” I address three strategies that are important in order to embrace change. To download a free copy of my e-book that covers this, click here.

As always I welcome your comments and suggestions about more topics you would like to learn about.
To your health & wellbeing,

Today’s Health Awareness Topic – Women and Heart Disease

 

heart healthFebruary is heart health month. I am committed to helping women, especially women living with chronic illnesses such as diabetes, learn all they can to enhance their health and wellbeing.

But I have found that a lot of women do not know the facts when it comes to heart disease. Only 54% of women know that heart disease kills more women than breast or lung cancer.
According to the most recent statistics by the Centers for Disease Control, heart disease is the leading cause of death in the United States in women over the age of 35 years.

Although the rate of death from heart disease for men has dropped in the last thirty years, they have not done so for women. In 2013, heart disease was responsible for killing close to 290,000 women. This translates to 1 in every 4 women dying due to heart disease.

There used to be a time when there was a general belief in the medical community that women under the age of 50 could not suffer a heart attack. So you can imagine what happened if you were a woman and you went to see your doctor with a complaint of chest pain. Your doctor would usually reassure you that it was not your heart and perhaps you had indigestion or were under a lot of stress and prescribe something for that.

As a woman it is extremely important to arm yourself with facts about your heart health.

Some other heart health facts that you need to be aware of:

  • Heart disease will kill six times more women this year than breast cancer.
  • 71% of women do not experience the early signs of a heart attack as chest pain as do men. They may experience a sudden onset of weakness. Almost 2/3rds of women who die suddenly of heart disease did not have any symptoms.
  • Women who smoke are twice as likely to have a heart attack as men who smoke. The risk of a heart attack is 19 years earlier than women who do not smoke. So think about it, if you are a woman and you have been smoking since you were in your teens (which by my experience is the time that most people start a bad habit like smoking ☺), then your risk of having a heart attack begins to rise toward your forties.
  • Type 2 Diabetes increases a woman’s risk of developing heart disease. Women living with diabetes who have had a heart attack have double the risk of having a repeat heart attack in their lifetime or developing heart failure.
  • Women with metabolic syndrome have an increased risk of developing heart disease, especially at a younger age.
  • Women under the age of 50 have twice the risk of dying from a heart attack as men in the same age range. This is all the more reason to be persistent when something does not seem right. I have often shared that as women we have an inner knowingness about ourselves and/or situations. This is called intuition and you can learn to use it to guide you in all aspects of your life.
  • Marital stress worsens the outcome of a heart attack.

What happens to you when you have a heart attack?

When you develop a heart attack, the blood supply to an area of the heart muscle gets blocked off. Sometimes the blockage may not be a complete blockage and blood can still get by to the heart muscle. This is called ischemia or angina. The classic symptoms of angina are chest pain, chest discomfort, and chest heaviness. Sometimes the pain or discomfort may go down the left arm or into the jaw.

As women we may have what is called ‘atypical symptoms’ like unusual weakness, heartburn, dizziness, etc.

But remember just as I pointed out, some women may not have the classic presentation of a heart attack or angina.

The good news is that if the blood supply is restored at this point, then no permanent damage occurs to the heart muscle.

When the blood vessel to a particular are of the heart remains blocked for a period of time, eventually the heart muscle begins to die off. Sometimes the damage cannot be reversed and the heart muscle dies and it is replaced by scar tissue. Scar tissue reduces the functioning of the heart and eventually causes heart failure and death.

It is important to get to an emergency room as soon as possible if you develop any symptoms suspicious for a heart attack. This is because the sooner you get intervention by a heart specialist to open up the blocked vessels the less the risk of permanent damage to your heart.

What you can start doing today:

  • Become knowledgeable about your risk for heart disease. Even if you do not have a family history of heart disease you can still be at risk!
  • If you smoke then quit. No more excuses! It’s still early in the year and you know you can do it.
    If you are obese or even over 10% of your ideal body weight, then commit to losing weight.
  • Schedule your annual physical and know your numbers! These numbers include- your blood pressure, fasting lipid profile (cholesterol), and blood sugar. If any of these numbers are outside of normal range then take action and work on getting them back to normal.
  • If you have high blood pressure or borderline diabetes or type 2 diabetes, then make sure that you are being treated by the appropriate healthcare professional. Do not ignore this part of your care. Denial only worsens things in the long run.
  • Find ways to cope with stress in your life. Stress is so prevalent that we as humans do not believe they can live a stress free life. It is our perception of stress that matters and what we do to modulate its effects.

Now more than ever we as women need to become more pro-active in our overall health and wellbeing. We need to stop making excuses for poor lifestyle choices. More importantly we need to accept that these lifestyle choices not only shorten our lives, but also the quality of the life that we have left. I’m not sure about you but I want to be health and vibrant into my 90s and beyond!

My mission in creating this blog is to provide a whole person approach to living with type 2 diabetes and other chronic illnesses.

Along those lines, over the next few months, in addition to the release of my updated book, Dr. Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’, I will  be rolling out several programs. I look forward to working closely with those who are willing to invest the time and effort to enhance their health and wellbeing.

 

 

Today’s Health Awareness Topic: The relationship between your emotions and diabetes symptoms

 

 

 

 

People living with diabetes  may experience a wide range of emotions on a day-to-day basis. These emotions may range from initial anger, resentment, disbelief, and even denial. At times these emotions can be very intense. Sometimes these negative emotions are inappropriately directed at the healthcare provider who gave the bad news of the diagnosis.

Being diagnosed and living with type 2 diabetes does not have to be a stressful experience. Consider that contrary to popular opinion, being ‘stressed out’ does not have to be part of living with any chronic illness including type 2 diabetes.

It is predictable that over time, your emotions will wax and wane. Some days you may feel more upbeat than other days. Rest assured that you are OK. One of the first things that I do with my patients and clients is to work on getting those emotions out in the open so that we can deal with them at the outset.

You have the power to choose how your emotions impact your overall health and well being.

This is especially important if these emotions are not empowering. We all have the power to choose how our emotions impact us. I know this may sound so cliché. But really and truly this is one of the times that you get to choose and that choice directly impacts your blood sugar control. Living with diabetes is a prime example where having the power of choice impacts your overall health and blood sugar levels.

If you are constantly stressed out and angry then it’s predictable that it may be more challenging to get your blood sugars within normal range.

Stress causes the release of hormones in the body. The stress hormones are called adrenaline, noradrenaline and cortisol. These hormones help to prepare the body for ‘fight or flight’. One way that they prepare us for ‘fight or flight’ is by increasing the production of glucose from the liver stores. This is a normal stress response.

However, when you have diabetes, the last thing that you need is more sugar in your blood stream. Your body is already not able to handle the glucose that it has already!

Research has been performed on the effects of a positive mood on our overall health and well-being. On a chemical level, being happy helps to reduce stress hormones. It enhances the release of endorphins and natural serotonin both of which enhances our emotional state and enhances our well-being. If you have a positive and optimistic mindset, then you will feel more empowered in finding ways to better control your blood sugars.

The first step to living an empowered life with diabetes is to get those emotions out in the open. The next step is to deal with these emotions.

It can be challenging for healthcare providers to be able to address all the emotional concerns of our patients  living with a chronic illness. There is no  doubt the 15-minute ‘double-booked’ appointment slot may not help us to connect with our patients and understand how they are actually experiencing their disease but this discussion is important. Be certain to speak to your healthcare provider if you are feeling stressed out or overwhelmed.

Over time some people living with diabetes may begin to experience what is known as diabetes distress.  Diabetes distress is not true depression. Some patients may need the support of talk therapy. It may be helpful to work with a health coach or a psychologist.

As a professional life coach and a physician my stand is for patients and clients living with type 2 diabetes or any chronic illness to experience a vibrant wholesome life.

It is what motivated me create this platform as a way to empower women living with diabetes.

By empowering women, we empower our communities and eventually the planet.

One of the most important things to do is to deal with your mindset and your perception of living with diabetes.

In the first three chapters of the soon to be released updated version of my  book, ‘Dr. Eno’s A-Z  Guide to Living Powerfully with Diabetes’ I write about what I can best describe as the ‘ABCs of a positive mindset’.

They are:

  • A-Acceptance
  • B-Belief
  • C- Commitment to change

Yes you have the power to choose whichever way it goes. Remain committed to how your health and well-being even on days that you may not feel your best.

To take a FREE peek of the first three chapters my upcoming book, click here.

To your Health & Well-being,

How fiber can help reach healthy blood sugar levels in type 2 diabetes

type 2 diabetesA friend of mine was recently sharing me how frustrated her husband was with his blood sugar levels. They seemed to fluctuate widely from high blood sugar levels to low blood sugar levels. He did not know how to react to this and had decided that he was not going to take his medications any longer. Naturally she was at her wits end when she reached out to me. How could she convince her husband that stopping his medications was not the way to deal with fluctuating blood sugars?

Fluctuating blood sugars are not unusual in type 2 diabetes. Whether you are a woman living with diabetes or you know someone living with diabetes, this can be very frustrating .

Let me start by normalizing this for you. You are not alone. There are many reasons why the blood sugars fluctuate. I will cover this topic in more detail in an upcoming article.  In addition to scheduling an appointment to see your healthcare provider, you may also need to make sensible lifestyle changes- to your diet and exercise regimen.

One of the ways things to tweak in diet to increase the amount of fiber. Fiber is a form of carbohydrate. Contrary to popular belief, not all carbohydrates are bad for you!

There are two kinds of fiber-soluble fiber and insoluble fiber. Insoluble fiber does not get absorbed from the intestinal tract. This kind of fiber helps to reduce constipation. Soluble fiber has many proven benefits. Soluble fiber gets absorbed into the bloodstream and so can help regulate blood sugars. It also helps to control cholesterol levels.

Soluble fiber can help to reduce the risk of stroke and heart disease by up to 50%. This is especially important for someone living with type 2 diabetes, where the risk of stroke and heart attacks is increased.

Another benefit of soluble fiber is that it help reduce hunger by maintaining a sense of fullness. This can be useful in weight management. When you feel full you tend to eat less. 

Research has proven that simply losing 10% of your body weight helps to prevent borderline diabetes from becoming full blown type 2 diabetes. Some examples of soluble fiber include psyllium, pectin and wheat dextrin and oat products.

So exactly how much fiber is enough?

 Women should eat about 25 g of fiber and men up to 38 g of fiber a day. With the ‘standard American diet’ we consume an average of 17 g fiber per day.   A study in the New England Journal of Medicine found that by increasing daily fiber up to 50 g, a person living with diabetes was able to achieve healthier blood sugar and cholesterol control.

Some ways that you can start to increase your fiber intake? 

 I usually recommend gradually increasing fiber in your diet. Remember this is a long-term change you are making to your lifestyle.  If you rapidly increase fiber, it may cause gas and abdominal bloating. Too much fiber could also cause constipation if you do not drink enough water.

 So here are some suggestions on ways to increase your fiber intake: 

  1. Create a list of fiber rich foods.  You can do research this online. Click on this link to research a variety of food sources that have high fiber content.
  2. Try experimenting with some new sources of fiber every day.
  3. Gradually increase your fiber intake by 5 g per day until you reach the goal.
  4. As you increase fiber intake also make sure to increase your water intake to reduce bloating and constipation.

Remember to be kind and patient with yourself. There is no quick fix to diabetes. Your goal is to achieve healthy blood sugars so that you reduce the complications associated with diabetes. Increasing the amount of fiber in your diet can be one of your most powerful tools in achieving healthy blood sugars. So start today to take simple small steps each and every day and don’t give up.

To your health and wellbeing,

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