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In November, healthcare professionals around the country will be busy raising awareness about diabetes during National Diabetes Month. Hope Warshaw, RD, CDE, is one of them. In fact, she has been a diabetes educator and advocate for nearly 40 years, counseling people to better health, traveling the country to speak about the disease, and writing a number of books including her latest, Eat Out, Eat Well – The Guide to Eating Healthy in Any Restaurant, published by the American Diabetes Association. Recently, she took time to talk with us about diabetes.

Diabetes in America


Did you know that every five minutes, sixteen American adults are newly diagnosed with diabetes? According to the Centers for Disease Control and Prevention (CDC), nearly 10% of the U.S. population has been diagnosed with type 2 diabetes, affecting people of all ages and ethnicities. Another one in four people aren’t aware they have it.

In addition, the CDC estimates 86 million people have prediabetes, meaning that they have higher than normal blood glucose levels, but not yet high enough to be diagnosed as diabetes. It also means that they have an increased risk of developing type 2 diabetes, and without weight loss and moderate exercise, the CDC estimates that 1530% of these people will develop the disease within 5 years.

“One thing people need to be aware of,” says Hope, “is that prediabetes and type 2 diabetes are progressive. When they are not taken seriously from the diagnosis, and healthy lifestyle changes are not made and followed long term, it’s difficult to slow their progression. Treatment over the years can be more challenging.”

People with newly-diagnosed diabetes should talk with their healthcare provider about management options and the very important lifestyle changes to make. They should be sure to ask for a referral to a diabetes educator or diabetes education program for initial education and support.

”People with prediabetes should be encouraged to lose 5–7% of their body weight and work hard to keep that off through the years. This can help prevent or slow their risk of developing type 2 diabetes. Research shows the best way to accomplish this is by eating healthier, eating smaller portions and being more physically active.”

“Taking these actions can be challenging in our current food and cultural environment,” she adds. “Eating healthier for many people is really about making changes in eating habits and food choices.”

To help people move towards a healthier lifestyle, Hope shared these four tips, which she considers key to this process:

1) Plan ahead.

“It’s one of the most important things to do. Being aware of your goals and needs each week really helps you succeed. That means knowing what foods you have in your pantry, foods you need to purchase, how and when you’ll prepare your meals and where and what you’ll eat away from home. For example, can you make a big quantity of a healthy casserole one weekend day to have a few dinners at the ready when you arrive home from work? All this takes effort, especially at the beginning, but gets easier the more you do it.”

2) Choose restaurant foods wisely.

Research confirms that the more food we have in front of us, the more we’ll eat, so controlling portions is essential. “When you’re eating restaurant meals, portion control starts from the moment you glimpse the menu board or have a menu placed in your hands. A good strategy to follow is to order smaller portions in the first place, or split menu items.” She adds, “Another is to ask for a take home container upfront; when your food arrives, portion out what you’ll eat at the table and what you’ll take home.”

Whether at home or at a restaurant incorporate more whole grains, fruits, vegetables and low fat dairy foods in your eating plan, they’re not only nutritious, they’re filling, too.

3) Embrace the concept of “displacing” your food.

“This is really a tactic of switching one food for another. For example, at a restaurant, (especially at those serving pasta dishes) ask for a small bowl of marinara sauce and dip your bread in it instead of slathering butter or oil on your bread. Rather than eating foods high in saturated fats, such as a thick steak, eat fish once or twice a week instead. By virtue of choosing something healthier, you’re saving calories and eating healthier fats, too. Have fun with this, challenge yourself to see how you can enjoy your meals with these new choices.”

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4) Be physically active.

“I can’t stress this enough. More and more research is showing that a sedentary lifestyle is hazardous to our health, no matter who we are. Get up, move. At the office, stand up and walk around every 90 minutes; take the stairs whenever you can; take a walk after dinner; ride a bike. It’s been shown that blood glucose and insulin resistance (a core problem in prediabetes and type 2 diabetes) with regular physical activity can be improved.”

The American Diabetes Association states that in the short term physical activity can lower blood glucose for 24 hours or more after exercise, making our bodies more sensitive to insulin. When someone is active on a regular basis it can help keep blood sugar levels stable.

As we learn more about prediabetes and type 2 diabetes and how we can delay or prevent their onset, these tips can help everyone live a happier and healthier life, whether or not they’ve been diagnosed with diabetes.

For more information and resources on diabetes and healthy eating, please visit Hope Washaw’s website, the Center for Disease Control and Prevention, the American Diabetes Association, and our ONE Diabetes toolkit.

~ Deborah Plunkett, Oldways Nutrition Exchange


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Thank you for this steps to stay healthy along with diabetes and the diet plan is amazing.

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