Correcting a Lifetime of Unhealthy BehaviorsFriday, December 16, 2011
The Mayo Clinic Diabetes Diet book takes a holistic approach and offers strategies to lose weight and improve the lifestyle habits of people with type 2 diabetes as well as those who might be in danger of the condition.
By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net
The American literary landscape is filled with numerous diet books directed at various ways to lose weight. While these books have been around for decades, a good portion of them stay closely within the realm of ’going on a diet’, looking at specific nutritional plans to help dieters to lose excess weight. They often do not look at the entire lifestyle of people in terms of what it takes to not only begin to lose weight but successfully keep it off over the long-term. These types of books often don’t emphasize important weight management elements like physical activity, a person’s psychology, and behavior management.
Ineffective diet programs may help people lose weight in the short term, but often result in a yo-yo effect where a person is constantly battling their weight and watching it go up and down, sometimes for years. These people can go through periods of feeling good at a favorable weight and then have a setback and gain a lot of weight back and resort to familiar unhealthy behaviors.
Compounding matters, the overall American populace is becoming more obese and a potential national epidemic of disease is on the horizon, namely the biggest three that affect the country’s mortality rates: heart disease, cancer, and now diabetes.
This last one is especially disturbing as the current figures show the greatest prevalence of Americans with type 2 diabetes ever recorded and the trend expected to go up.
Knowing there was an absence of comprehensive diet books and a burgeoning trend of obesity, the world renowned Mayo Clinic has written its own book, The Mayo Clinic Diabetes Diet.
The marked difference in this book from others is that it takes a holistic approach incorporating nutrition, physical activity, and behavior as a means for losing weight and developing sustainable lifestyle changes. The book is broken down into two main parts: the "Lose It!" and "Live it!" sections.
As the name suggests, the “Lose It!” phase is devoted to teaching people to lose weight quickly and safely. The “Live It!” phase is a long-term plan and aims to help people lose 1 to 2 pounds weekly until people reach their goals. A third section, “All The Extra Stuff” includes everything from diabetes-friendly recipes, to meal planners to behavior management skills in order to help people in these areas. There is a companion workbook, The Mayo Clinic Diabetes Diet Journal, which provides people with a place to record their diet, activity records, and write in their goals as they continue on their weight loss program.
This is the type of book that should be highlighted, photocopied, dog-eared, and possibly even become loosened from its spine due to constant use. It can be referenced to on a regular basis as a diabetes dieter works his or her own way through this program.
Donald Hensrud, MD, MPH, the chief medical editor of the book, collaborated with a team of Mayo medical professionals from various specialties in compiling this book. Dr. Hensrud is a specialist in nutrition and weight management, and he is the past president of the American Board of Physician Nutrition Specialists. Dr. Hensrud conducts research in weight management, lectures widely, and assisted in publishing two Mayo Clinic cookbooks. He also was the medical editor for the medical center’s earlier book, The Mayo Clinic Diet, which was a #1 New York Times bestseller.
Dr. Hensrud (pictured, right) acknowledges it is an uphill battle trying to get people to go against the grain of a lifetime of poor health habits, but in addressing the various segments associated with losing weight and keeping it off, the Mayo Clinic looks to help people not only kick start their weight loss, but then learn strategies they can come away with for a new healthier lifestyle.
DiabetesCare.net spoke with Dr. Hensrud about some of the important elements of the book, the team approach in writing the book, and how it can help people with type 2 diabetes.
DiabetesCare.net: Can you provide an overview of the book including the two main sections?
Dr. Hensrud: It is more than a diet, it is a program. The program is divided up into two phases. Lose It! is a quick-jump start weight-loss phase. This section of the book was written to help people make sudden, yet healthy, changes in their lifestyle habits related to diet, physical activity, and weight management.
Since weight is the strongest controllable factor for improving blood sugar, people with type 2 diabetes can start to improve their control right away.
Next there is the Live It! phase, where people take these improved habits and turn them into long-term sustainable changes. The last part includes an action guide. Everyone experiences challenges while dieting, so we took peoples’ obstacles while trying to lose weight and provided them with strategies on how to deal with these challenges. In the Live It! phase, we also introduce people to the principles of the Mayo Clinic Healthy Weight Pyramid.
DiabetesCare.net: Why the decision by Mayo Clinic to write this book?
Dr. Hensrud: We saw a need. The majority of people who have type 2 diabetes are overweight or obese. Although risk factors for the diabetes include a genetic disposition and a person’s age, weight is the number one aspect people can control as a risk factor as it relates to glucose control.
At Mayo, we pride ourselves on our clinic work, research, and education, and we wanted to provide a source of credible and accurate information for people with this disease to develop a program that is safe and effective to better control their diabetes and their overall health.
DiabetesCare.net: How does this book stand out from other diet books?
Dr. Hensrud: We took elements of this diet program from evidence-based clinical research that have been shown to be effective. We brought the various elements together to create a holistic approach. We also tried to do it in a way that is simple and empowers people.
DiabetesCare.net: What is the most challenging aspect of people with type 2 diabetes in following self-care lifestyle changes as they pertain to weight-loss?
Dr. Hensrud: I think the most difficult thing is making sustained lifestyle changes in health behaviors regarding diet, physical activity, and weight. It is difficult for anyone to try to lose weight, but it is particularly difficult in people with diabetes.
DiabetesCare.net: The book really delves into exercise, which many diet books don’t do, why?
Dr. Hensrud: This program is not just about one aspect, but overall health improvement. In order for a person with type 2 diabetes to improve glucose control, the three most important elements are weight loss, physical activity, and diet. Weight loss almost always leads to improved glucose control. Exercise has an effect on weight, but it also has an independent effect on glucose control. When people are more active, even when they are not losing weight, their glucose numbers may improve.
DiabetesCare.net: The book uses a team approach including MDs, CDEs, PhDs, and RDs. What are the advantages to having multiple contributors from different professional specialties, and does Mayo take this same approach in diabetes treatment?
Dr. Hensrud: In virtually all of our clinical care, we operate in teams and that is one of the strengths of Mayo Clinic. When you come at this program with different perspectives, you get the expertise of all the various medical experts. For example, the psychology of weight loss is important and we have a discussion in the book as it pertains to this subject. Our RDs who contributed to the book also play a very significant role. We bring the expertise of several different backgrounds so that the whole is greater than the sum of its parts.
DiabetesCare.net: For people following the Lose It! section, what is the percentage of weight loss that diet followers of the book can expect to lose in the first couple of weeks?
Dr. Hensrud: People with type 2 diabetes sometimes have a more challenging time to lose weight, so the percentages will vary, depending on how many of the habits they are willing to change. The greater the number of habits they change, the greater the weight loss can be. We did a pilot program in people without diabetes, and most people lost six to ten pounds in that program.
Also, people who weigh more may carry more water weight and may lose a bit more in the beginning. So there will be variability in the weight loss of dieters.
DiabetesCare.net: Should people talk to their medical providers first before engaging in this diet? Should there be some health parameters put in place beforehand?
Dr. Hensrud: One of the considerations in beginning a diet program is that people with type 2 diabetes are at a greater risk of cardiovascular disease, so if they go from a very sedentary lifestyle to then trying to do too much, too fast, then dieters might run into health issues. People in this category should talk to their health care providers.
Also, this program is not necessarily targeted for people on insulin, but if people are on insulin, they should definitely work with their medical provider on adjusting their dose when necessary. When someone makes quick changes, their glucose control can fluctuate, even before losing weight. For example, the decrease in caloric intake will improve blood sugar right away.
However, it is important to point out this is a very safe program. The Lose It!, quick weight loss section is safe for new dieters. Still, in general we think people should consult their medical provider to make sure he or she is in the loop with the dieter’s progress.
DiabetesCare.net: A lot of this information seems like it could be applicable for people with metabolic syndrome or prediabetes. Do you see these people as a potential audience for this book?
Dr. Hensrud: Absolutely. The same principles and programs that apply to people with diabetes also apply to people with prediabetes or metabolic syndrome.
DiabetesCare.net: What are your hopes for this book?
Dr. Hensrud: The book doesn’t have a glitzy hook or the promise of the fountain of youth. Some diet books have methods for many people to lose a substantial amount of weight within a very short period of time; however, it is much more important to sustain weight loss over the long term. We have a solid program that is safe, effective, and can help people do this.