Not Just for Weight Loss: Battling Disease with a Low-Glycemic Diet
In This Chapter
▶ Using a low-glycemic diet to help you with health issues you may already have
▶ Staying healthy and preventing chronic diseases with your new low-glycemic diet
▶ Discovering low-glycemic foods that are rich in antioxidants and phytonutrients
Whether you’re healthy or you have either preexisting health conditions or a family history of certain health issues, following a low- glycemic diet can help you in many ways. Originally studied for diabetes and insulin-resistance disorders, the glycemic index is now being looked at more and more for other positive effects such as promoting heart health. Even though the glycemic index has been around for a while, the research is really picking up the pace lately, and I imagine there will be more and more exciting discoveries along the way.
In addition to helping you manage certain health conditions, a low-glycemic diet also lends itself well to disease prevention. This characteristic of the diet is especially important if you’re feeling healthy now but happen to have a family history of heart disease or diabetes. You can make many changes in your lifestyle to avoid developing these health problems yourself, and a low- glycemic diet is one of them.
If you have close family members living with chronic health conditions, you know firsthand how they can affect your quality of life. This chapter is all about how you can take control with small changes to your way of life that add more nutrient-rich, low-glycemic foods to your diet.
Managing Existing Health Problems
For many people who are serious about weight loss, the desire to shed pounds goes beyond just wanting to fit into “skinny jeans.” It’s about helping manage an existing health issue. Most of these issues center on insulin resistance, a condition in which the body can’t handle the sugar in the blood provided by the food you eat (see Chapter 5 for full details). Insulin resistance can make losing weight difficult. Then again, if you gain too much weight, the insulin resistance gets worse. It’s a vicious cycle that can become quite frustrating. If you’re in the middle of this cycle right now, I’m sure you can relate to the challenges it creates. But hope is here. Following a low-glycemic diet has been found to be of great success for those dealing with insulin resistance because eating low-glycemic foods keeps blood sugar from spiking as much, thereby requiring much less insulin.
Research is also pointing out benefits of a low-glycemic diet for other health issues such as heart disease and even hypothyroidism. The sections that follow focus on several specific health issues and how following a low- glycemic diet can improve your quality of life if you have one of them.
If you have diabetes, Polycystic Ovary Syndrome, hypothyroidism, heart dis- ease, metabolic syndrome, or hypoglycemia, be sure to consult your doctor before diving headfirst into a low-glycemic diet. He or she may want to monitor your health condition more closely as you make changes to your diet.
Regardless of your specific health condition, there are several signs that following a low-glycemic diet is doing your body good. Celebrate your transition to a low-glycemic diet if you experience any of the following:
✓ Fewer food cravings
✓ Increased energy
✓ Weight loss
✓ Decreased insulin levels
✓ Decreased blood sugars
✓ Improvement in disease management
Diabetes
Diabetes is a disease in which the body either doesn’t produce enough insu- lin or doesn’t use it properly. The human body uses insulin to convert sugars into the energy needed for daily life. Think of it as a key that unlocks the door to your cells so the sugars from the food you eat can enter your bloodstream and be used as energy. This system is impaired in people with diabetes, causing them to have excess blood sugar and high insulin levels. Following a low-glycemic diet helps you avoid large blood sugar spikes so you can more easily control your blood sugar with less insulin. (Why? Because low- glycemic foods release sugar into your body more slowly than high-glycemic foods.)
Scientists haven’t always been certain that low-glycemic diets make a big impact on diabetes because of all the variables involved, such as portion size and the individual way people metabolize sugars. A recent review of current research looked at whether a low-glycemic diet or a low glycemic load diet (which takes portion size into account; see Chapter 4 for details on glycemic load) helped people with Type 1 diabetes and people with Type 2 diabetes manage their blood sugars. The results showed that a low-glycemic diet helps with both types of diabetes. Researchers found that following a low-glycemic diet decreased Hgb A1C levels by .5 percent. (Hgb A1C is a lab measurement that gives a big picture of a person’s blood sugar over several weeks or months.) Another review of research studies found that a low-glycemic diet resulted in decreased Hgb A1C levels by .43 percent compared to diets touting high-glycemic foods. The conclusion from this review? Following a low- glycemic diet has a small but clinically useful effect on blood sugar control. More research is needed, but clearly studies are showing that a low-glycemic diet can be helpful in managing both types of diabetes.
If you have diabetes, you’re probably familiar with carbohydrate counting. Don’t throw that out the window; doing so could be detrimental to your health (and could get you in trouble with your doctor!). Instead, continue using carbohydrate counting and other tools while also using a low-glycemic diet as a way to choose good carbohydrate sources. Being diabetic means you need to pay more attention to your food intake (what, how much, and when). If you haven’t seen
a registered dietitian, now would be a great time to schedule an appointment to help put all of these puzzle pieces together into a manageable form.
Here are some simple dietary guidelines for using a low-glycemic diet to help manage your diabetes:
✓ Be cautious of portion sizes. Much of the glycemic load information out there is based on smaller portions than you may eat normally.
✓ Eat healthy foods that are low-glycemic instead of loading up on low-glycemic foods that aren’t so healthy. Junk food (think Snickers bars and chocolate cake) is still junk food, no matter how low the glycemic level.
✓ Always test your blood sugar so you can monitor how your dietary choices are stacking up. You’re a unique individual and may metabolize foods differently than others. That’s why it’s important to keep track of what’s going on with you and only you.
Polycystic Ovary Syndrome
The hormones of women who have Polycystic Ovary Syndrome (PCOS) are out of balance, which leads to various problems, including ovarian cysts, irregular menstrual cycles, fertility issues, weight gain, acne, skin tags, excess body and facial hair, and thinning hair on the scalp. If left untreated, PCOS can lead to diabetes and heart disease. The exact reason PCOS occurs isn’t yet known, but scientists believe there may be a link between insulin resistance and PCOS, which is why a low-glycemic diet is helpful.
Insulin resistance reduces insulin sensitivity, which causes less blood sugar from the foods you eat to enter your cells to be used as energy. The cells become resistant to insulin, and the pancreas responds by releasing more and more insulin to help the blood sugar enter the cells. In return, these high insulin levels stimulate the ovaries to produce large amounts of the male hormone testosterone, which in turn leads to symptoms such as infertility and ovarian cysts. This buildup of blood sugar remains in the bloodstream and
is sent to the liver and muscles. After it reaches the liver, it’s converted to fat and stored throughout the body, leading to weight gain and obesity. You can see what a challenging health condition PCOS is. If you have it, I’m sure you’ve experienced many of these obstacles to your well-being.
Getting blood sugar and insulin levels under control is a key factor in treating individuals with PCOS, and following a low-glycemic diet can help lessen blood sugar spikes and keep insulin levels down. It can also help reduce the weight gain that results with PCOS. Granted, further research is still required to gauge the exact impact of a low-glycemic diet on PCOS, but until that data is available, know that this diet provides you with a good strategy for getting your blood sugar and insulin well under control.
If you have PCOS and want to try a low-glycemic diet, follow these guidelines:
✓ Choose low-glycemic carbohydrates in the appropriate portion sizes for meals and snacks.
✓ Eat a diet that gives you 40 to 50 percent of your calories from carbohydrates (compared to the normal 60 percent). Although research is needed in this area, many professionals agree that women with PCOS do better with a lower-carbohydrate diet.
✓ Space your carbohydrates throughout the day to avoid blood sugar spikes at one meal.
✓ Avoid consuming carbohydrates by themselves even at snack time.
Couple them with a protein or fat source instead.
✓ Choose high-nutrient, low-glycemic carbohydrates and limit your intake of low-nutrient foods.
Note: You may need to obtain regular guidance from a registered dietitian who specializes in PCOS to find just the right low-glycemic fit for you.
Hypothyroidism
Thyroid hormones are in charge of your body’s metabolism. People with hypothyroidism don’t produce enough thyroid hormone, which means they have a slower-than-normal metabolism. The symptoms of hypothyroidism are numerous and include fatigue, depression, muscle pain and weakness, joint stiffness, and a puffy face. But, as you can imagine, two of the biggest symptoms are weight gain and difficulty losing weight. The weight gain can be significant and happen very quickly. I actually have hypothyroidism and gained 10 pounds right away when I was first diagnosed, but others report anywhere from a 30- to 50-pound weight gain in a short period of time.
As you gain weight, your fat cells begin to fill up with fat. When this happens, insulin receptors in the cells can become blocked, causing them to respond inadequately to insulin and blood sugar. That high blood sugar causes your pancreas to secrete more insulin to help remove the blood sugar from the bloodstream so it can enter the cells. Too much insulin increases your hunger levels and can lead to a cycle of overeating and more weight gain.
Used in conjunction with medication, a low-glycemic diet can help normal- ize your body’s metabolism if you have hypothyroidism. It can also give you better control of your
✓ Blood sugar and insulin levels: Recent research is finding a connection between hypothyroidism and insulin resistance. Specifically, hypothyroid- induced weight gain may cause some people to develop insulin resistance. More research is needed in this area, but for now following a low- glycemic diet to better control blood sugar and insulin is a safe bet.
✓ Dietary choices: You may have been able to eat a diet that was more moderate before, but dealing with hypothyroidism tends to require a little more structure of one’s food choices in order to manage weight. A low-glycemic diet provides that needed structure, while still allowing for variety. Eating a low-glycemic diet and following the healthy-eating
strategies in Chapter 9 will help you control your calories, eat high-fiber, high-nutrient foods, and mange your weight more successfully.
Put these tips into practice to make a low-glycemic diet work for you if you have hypothyroidism:
✓ Try to eat every four to five hours to avoid the negative effect on your metabolism caused by skipping meals. (See Chapter 8 for more on metabolism.)
✓ Get moving! You can’t just rely on the foods you eat (or don’t eat) to boost your metabolism. Help pump up your metabolism by engaging in calorie-burning, muscle-building activities (flip to Chapter 21 for some ideas for adding physical activity to your life).
✓ Keep a record of your food intake to see what, when, and how much you’re consuming. Many times people don’t realize how big their portions truly are. (Head to Chapter 6 for pointers on starting a food journal.)
Heart disease
Heart disease takes many different forms, all of which affect the heart in different ways. The one common thread? If serious enough, any form of heart disease can interfere with your heart’s life-sustaining pumping.
One example of how the low-glycemic approach can help heart health relates to triglycerides. Many foods that are high in sugar are high-glycemic. Too many of these foods (and their effect on your body’s blood sugar and insulin functioning) can elevate triglyceride levels, posing increased risk on the heart. The research has been a bit conflicting, but an average of the responses from 37 studies published in the American Journal of Clinical Nutrition shows that following a low-glycemic diet has a consistent benefit for heart health. Specifically, findings demonstrate that eating a low-glycemic diet increases HDL (good) cholesterol and lowers triglycerides. This result may be due to the decreased intake of most sugary foods or the increased intake of high-fiber foods — either way, it’s a good thing.
Healthy fats and fiber are still a big part of the overall healthy heart picture. Don’t forget about them. Instead, weave information about a low-glycemic life- style into what you already know about good nutrition and heart health.
If you have risk factors for heart disease such as high cholesterol (or low HDLs) or high triglycerides and want to try a low-glycemic diet to help decrease these risk factors, here are a few tips:
✓ Choose low-glycemic carbohydrates in the appropriate portion sizes for meals and snacks.
✓ Eat high-nutrient, low-glycemic foods such as fruits, vegetables, and whole grains.
✓ Avoid trans fats and limit your intake of saturated fats (think high-fat cuts of meat and full-fat dairy products).
✓ Bulk up your fiber intake with a goal of eating 25 to 35 grams per day.
Not sure how much that is? Well, consider that a great whole-grain bread has an average of 3 to 4 grams of fiber in each slice.
✓ Increase your fruit and vegetable servings to five to nine servings per day.
✓ Eat plenty of omega-3 fatty acids, which are found in fish, walnuts, and flaxseeds. Note: Fatty fish such as salmon, tuna, and halibut are better sources of omega-3s than plant-based sources.
Metabolic syndrome
Metabolic syndrome (also known as Syndrome X or Insulin Resistance Syndrome) is a cluster of symptoms that include high cholesterol, high inflammation markers, high blood sugar, high blood pressure, high triglycerides, increased abdominal weight, and elevated insulin levels. This is a very tricky health condition, but diet can have a big impact on it if done in the right way. The hard part is you can’t just focus on fat for the cholesterol and inflammation; you also need to focus on carbohydrates for the blood sugar, insulin levels, and triglycerides. This balancing act requires a little more structure than some conditions, and a low-glycemic diet can provide this much-needed structure.
Because insulin resistance is so common among people dealing with metabolic syndrome (some health professionals even consider it to be the under- lying cause), a low-glycemic diet is key to managing this condition. By getting your insulin levels under control and losing weight, you greatly reduce your risk for developing multiple symptoms of metabolic syndrome.
So just how does a low-glycemic diet affect metabolic syndrome? Well,
✓ It helps reduce inflammation in the body. One study showed that women who ate higher amounts of whole grains, bran, and cereal fiber — all of which are important foods on a low-glycemic diet — had lower inflammation markers. Women who specifically ate a low-glycemic diet also had lower inflammation markers.
✓ It can decrease triglycerides by lowering the amount of excess calories, which can be converted into triglycerides, and reducing insulin levels, which can also increase triglyceride levels if they’re too high.
✓ It helps lower cholesterol levels and blood pressure by promoting weight loss. It’s also beneficial for cholesterol levels because of the increase in fiber intake, which helps remove excess cholesterol from the body.
Recent research shows there may be some excellent outcomes with losing a moderate amount of weight as well as eating low-glycemic foods. For people with metabolic syndrome, research shows a 6.5-percent reduction in weight can significantly reduce blood pressure, cholesterol, blood sugar, and triglycerides. Depending on your situation, this means you don’t need to lose a drastic amount of weight in order to make major changes in your condition. So, for example, someone who weighs 185 pounds only needs to lose 12 pounds to begin seeing significant results in her health status. Eating low-glycemic, high- nutrient foods can keep you feeling fuller for longer, cutting down on the cravings and eating binges that can make it tough to lose weight.
Here are some dietary tips for following a low-glycemic diet when you have metabolic syndrome:
✓ Pick low-glycemic carbohydrates for your meals and snacks, in reason- able portion sizes, and spread them out throughout the day to avoid experiencing a blood sugar spike in one sitting.
✓ Avoid eating carbohydrates alone; pair them with a protein or fat source.
✓ Decrease the amount of saturated fats and eliminate the trans fats in your diet.
✓ Start eating fatty fish, walnuts, and/or flaxseeds for their omega-3 fatty acids. (Omega-3s are also known to decrease inflammation.)
✓ Incorporate at least five servings of fruits and vegetables in your diet each day.
Metabolic syndrome can be extremely frustrating and scary because one condition (a symptom such as high blood pressure) can lead to another. Working with a team of health professionals is important to improve and/or correct these conditions. Speak with your doctor and meet with both a registered dietician and an exercise trainer. This team of health professionals can tailor guidelines to your specific needs so you can improve your overall health.
Hypoglycemia
In short, hypoglycemia is a condition that results when your blood sugar gets too low. Many people feel they have hypoglycemia, but an actual clinical diagnosis is rare and is most commonly seen in diabetics as a result of medications.
Even without a clinical diagnosis, you may be one of many individuals who’s sensitive to the highs and lows of your daily blood sugar. The symptoms of low blood sugar include
✓ Hunger
✓ Trembling
✓ Light-headedness
✓ Sweating
✓ Irritability or anxious feelings
Eating a low-glycemic diet counteracts hypoglycemia by maintaining an even level of blood sugar in your body throughout the day because you’re not overindulging in high-glycemic foods. Following a low-glycemic diet also helps control a situation called rebound hypoglycemia, which occurs when you eat a high-glycemic food that causes you to first experience a high blood sugar spike and then come crashing down quickly. (This description holds true even if you don’t have a clinical diagnosis of hypoglycemia but do feel some similar symptoms of low blood sugar.)
Avoiding the highs and lows of blood sugar can certainly make a big difference for people with hypoglycemia (or anyone who’s just plain sensitive to her blood sugar levels). Following are some tips for incorporating low-glycemic eating habits to help reduce blood sugar sensitivity:
✓ Eat frequent meals and snacks every three to four hours.
✓ Incorporate low-glycemic carbohydrates with protein and/or fat.
✓ If you’re diabetic, monitor your blood sugar regularly to catch times when it’s dropping. (Your physician can help you determine whether you need a change in your medication.)
Wellness and Disease Prevention
Many diseases can be prevented through lifestyle changes, starting with embracing a low-glycemic diet. This is another one of those messages that’s heard so much it somehow loses its value. You may think you have to make drastic changes in your diet and exercise to see a positive effect on your health, but the reality is that very small changes can make a big impact.
Perhaps the best change you can make is to increase your daily consumption of fruits and vegetables. Plant-based foods are powerful and can affect your health in many ways. I strongly encourage you to do two things: Work toward eating five to nine servings of fruits and vegetables each day and add beans, lentils, and whole grains to your daily menu. If you haven’t noticed the trend yet, the answer to weight loss, disease prevention, and managing existing diseases is increasing your intake of these plant-based foods, all of which are low in calories. Better yet, most are also low-glycemic and provide a significant source of fiber. So if you change up your plate to include more plant- based foods and fewer meats and starches, you’ll find the key to permanent weight loss and living your healthiest life.
In the following sections, I explain some of the ways in which the small dietary changes that come with a low-glycemic diet strengthen your body’s overall wellness and disease-prevention abilities.
Lowering your risk of chronic diseases
Did you know you don’t have to hit your goal weight to gain health benefits? You don’t need to eat a perfect diet to lower your risk of disease either. Research shows you can improve your overall health just by incorporating simple dietary and exercise changes. I don’t know about you, but this information increases my motivation because it means I don’t have to be perfect to optimize my health outcomes.
A low-glycemic diet works well for most people because it focuses on eating high-nutrient, plant-based foods. Guess what. Eating those same foods is also the key to weight loss, disease prevention, and wellness.
Following are some research statistics that show how making simple dietary changes (such as eating low-glycemic, high-nutrient foods) helps protect you from developing a chronic illness:
✓ Losing 5 to 7 percent of your body weight reduces the risk of chronic ill- nesses such as diabetes and heart disease.
✓ Estimates from a multistudy report show that if the only change people made was to include five servings of fruits and vegetables in their daily diet, overall cancer rates would decline by 20 percent.
✓ According to an article in the Journal of the American Medical Association, men and women with the highest consumption of fruits and vegetables, a median of 5.8 servings per day among women and 5.1 servings per day among men, were found to have a 31 percent lower risk of suffering from a stroke. One stroke can lead to a host of chronic health conditions (one of which is being at higher risk for having a second stroke).
✓ People consuming four or more servings of fruits and vegetables a day had a decreased risk for coronary heart disease. Those with an intake of at least eight servings a day produced an even greater decrease. Green leafy vegetables and vitamin C–rich fruits and vegetables appeared to contribute most to the apparent protective effect of total fruit and vegetable intake.
✓ The Nurses’ Health Study found that women who ate the most high-glycemic foods had a 50-percent greater risk of developing diabetes than those who primarily ate a diet of low-glycemic foods.
Although eating the right amount of low-glycemic, plant-based foods contributes a great deal to your body’s wellness and disease prevention, it doesn’t do the job alone. Other lifestyle components — exercise, smoking, alcohol intake, sleeping, and stress — matter too. Work on all aspects of your health to feel your best and significantly reduce your risk of developing a chronic disease.
The younger you are, the more important it is to start taking an active approach to your health. Many studies show that long-term dietary and health changes may make a bigger impact than short-term changes. All changes are good and will help you no matter what your age, but starting off when you’re younger gives you a leg up!
Fighting free radicals with antioxidants
Free radicals (unstable molecules) form when your body’s cells burn oxygen (scientists call this process oxidation). They also form when you smoke and when you’re exposed to sun, pollution, and harmful chemicals. Free radicals basically rip through your body and cause damage to your cells, tissues, and DNA, kind of how the Tazmanian Devil (that’s right, the old Looney Toons character) used to spin out of control, damaging everything in his path. The damage to your body caused by free radicals may leave you at greater risk for chronic diseases such as diabetes and cancer. What can defeat them? Antioxidants. These puppies save the day by neutralizing free radicals so they can’t cause damage.
Have you ever left an apple slice on the kitchen counter and come back an hour later to a brown apple? The browning effect is from oxidation. When you add orange juice to the apple slice, it stays white because it’s protected by the antioxidant vitamin C.
Free radicals will form in your body no matter how hard you try to decrease your exposure to the things that cause them. Consequently, your diet is your first line of defense. Luckily for you, many low-glycemic foods are also rich in vitamins that act as antioxidants — vitamin C, vitamin E, and beta carotene.
Before you go out and stock up on vitamins, you should know that supplements may not be the answer. Research on antioxidants and how they work in the body is ongoing. At this point, no one knows how much is too much or how the nutrients work together. Research suggests that there may be a synergy between the different vitamins and possibly other chemicals in food that give your body the antioxidant benefits. Therefore, taking a vitamin C supplement may not provide the same benefit as eating an orange.
Getting as many of your vitamins as possible from food sources is always best. Supplements are exactly that — supplements. They’re meant to supplement what you don’t get from your diet, not replace your diet. Instead of popping supplements, focus on eating a variety of low-glycemic fruits, vegetables, and whole grains to get the appropriate synergy of nutrients made especially for you by Mother Nature.
The beauty of embracing a low-glycemic diet for weight loss is that the better you follow the guidelines of filling up your plate with veggies and incorporating more fruits and whole grains into your meals, the more you naturally up your antioxidant intake. You don’t have to go out of your way to add something new. Instead, just get a good variety, which is more fun for your taste buds anyway!
Factoring in phytonutrients
Besides vitamins and minerals, plant-based foods offer phytonutrients, naturally occurring compounds with potential health benefits. To date, certain phytonutrients have been shown to work as antioxidants, contain anti-inflammatory properties, and promote heart health. Phytonutrients are found abundantly in fruits and vegetables, making your low-glycemic diet strategy a win-win.
Care to know a cool fact about phytonutrients? Well, in addition to providing great health benefits, they provide the pigment for fruits and vegetables, which means you can basically determine the health benefits a food offers
simply by looking at its color. Adding a variety of color to your plate can motivate you to diversify the types of plant-based foods you eat as well. Table 22-2 highlights the health benefits of certain colors of foods.
What’s your disease risk?
I’m guessing that someone you know (maybe even you yourself) has heart disease, high cholesterol, high blood pressure, diabetes, or some type of cancer. Nowadays even children and young adults have some of these issues. The good news is that making simple lifestyle
changes can help reduce your risk for these conditions. That’s right — lifestyle changes, not some magic cure or fad health or diet craze. Take the following quiz to determine your risk for disease and see what you can do to reduce it:
✓ Do you have a family history of heart disease, stroke, diabetes, or cancer?
These conditions have a genetic connection, so if your sibling, parent, grandparent, or other relative has, say, heart disease, you’re at greater risk for developing that too. I know many people take family medical history lightly, but knowing yours and acting on that knowledge is a good way to optimize your health now so you can avoid future complications.
✓ Do you smoke cigarettes?
Smoking has a direct correlation with some cancers (particularly lung cancer), cardio- vascular disease, and emphysema. If you’re a smoker, you can help protect yourself from these conditions by quitting. I know giving up smoking is often easier said than done for many. Find some help at www. smokefree.gov.
✓ For women, do you drink more than one alcoholic beverage a day? For men, do you drink more than two alcoholic beverages a day?
Alcohol is tricky when it comes to health. On one side, there have been reports that drinking alcohol, specifically red wine, can be beneficial to your health. However, these benefits only occur when you drink in moderation, meaning one beverage a day for women and two a day for men. When you go past this amount on a regular basis, you begin to have long-term health risks such as dementia, cardiovascular disease, stroke, and certain types of cancer. Keep your alcohol consumption to a moderate level to help avoid these problems.
✓ Do you eat at least three to five servings of fruits and vegetables a day, as well as whole-grain products?
Without these foods in your diet, you have little antioxidants at work for you. Start by making a list of all the fruits and veggies that you enjoy and begin incorporating them with every meal and snack. The recipe chapters in Part IV feature several ways to add delicious and nutritious fruits, veggies, and whole grains to your diet.
✓ Are you at a healthy weight?
A person may be statistically overweight without showing any signs of a major health problem. However, research shows that being overweight does lead to a higher incidence of diabetes and cardiovascular disease, as well as some cancers. Decreasing your weight by 5 to 7 percent can help lower your risk for developing these chronic diseases.
✓ Do you get regular exercise?
Lack of exercise is also connected with many chronic diseases. Fortunately, you don’t have to become a triathlete to get some of the major benefits of exercise. So long as you get at least 30 minutes of moderate physical activity at least five days a week, you’ll be doing your body right. If you’re a couch potato, why not work on walking for 30 minutes a day and then go from there? (Here’s a hint: You can break up that 30 minutes into smaller chunks if that makes it seem more manageable for you.)
If you answered yes to any of the first three questions and no to any of the remaining questions, you’re probably at a greater risk for dis- ease than you thought. Talk to your doctor and begin thinking about ways to implement some of the suggested lifestyle changes in your day- to-day affairs. Then make a commitment to yourself to stick with those changes!
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