tips for teens lower your risk for type 2...

Havemore energy,more fun, andfeel good

about yourself!

Today, more teens

than ever before

have type 2 diabetes.

Lower Your Risk forType 2 Diabetes

Tips for Teens

Take action now…check out tips to lower your risk ú

National Diabetes Education Program

What is type 2 diabetes?Diabetes means that blood glucose (GLOO-kos), also calledblood sugar, is too high. Glucose comes from the food we eat and is needed to fuel our bodies. Glucose is also stored in our liver andmuscles. Your blood always has some glucose in it because your bodyneeds glucose for energy. An organ called the pancreas (PAN-kree-as)makes insulin (IN-suh-lin). Insulin helps glucose get from your bloodinto your cells. Cells take the glucose and turn it into energy.

If you have diabetes, the pancreas makes little or no insulin or your cellscannot use insulin very well. Glucose builds up in your blood and cannotget into your cells. If blood glucose stays too high, it can damage manyparts of the body such as the heart, eyes, kidneys, and nerves.

If you have type 2 diabetes, you may need to take insulin or pills to helpyour body’s supply of insulin work better. Type 2 used to be called “adultonset diabetes.” Now more teens are getting type 2, especially if theyare overweight.

What puts you at risk?You are at risk if you: • are overweight • don’t get enough physical activity • have a mom, dad, or other close

relative who has type 2 diabetes • are American Indian, Alaska Native,

African American, Hispanic/Latino, Asian American, or Pacific Islander

FACT: Eating too much sugar does not cause diabetes.

Know the warning signs:If you have type 2 diabetes, you might: • urinate a lot • be very thirsty• lose weight without any reason • feel tired • have patches of thick, dark skin that feels like

velvet on your neck or under your arms

Some teens do not notice any of these warningsigns. They find out they have diabetes when theygo to their doctor for a check-up.

How will physical activityhelp? Like eating well, physical activity can help you feel good. Being physically active may:• help you control your weight, build

lean muscle, and reduce your body fat • strengthen your bones • increase flexibility and balance • improve your self-esteem and mood • help you sleep better• help you focus in school • improve your teamwork skills through sports

Okay, let’s get started: • Set small goals at first. Do not get upset if you can

not do a lot or if you get out of breath at first. Keepmoving! Any amount of activity will help. Add moreactivity each week until you reach your goal.

• Aim for at least 60 minutes everyday. You don’thave to do it all at once—20 minutes at a time, threetimes a day is okay, too. There are lots of ways to beactive. Go for a walk, ride a bike, dance, play ball, orshoot hoops. Choose what you like best, then do it!

Be active, eat well, and lower your risk!How can Ilower myrisk forgettingtype 2 diabetes?There are several ways to loweryour risk: • Stay at a healthy weight.• Be more physically active. • Choose to eat the right amounts

of healthy foods. • Follow the ideas on this tip

sheet and share them with yourfriends and family. They aregood for everyone’s health.

What can I do to be more physically active?

beactive

Aim for 3 cups a day. Hereare choices that equal 1 cup:• 1 cup nonfat or low-fat milk

or yogurt• 11⁄2 ounces cheese

Vegetables

Your Healthy Food Guide

Aim for 5 to 6 ounces a day. Hereare choices that equal 1 ounce:• 1 ounce lean meat, fish, or chicken• 1 egg• 1 tablespoon peanut butter• 1⁄2 ounce nuts • 1⁄4 cup cooked dry peas or beans such

as kidney, white, split, or blackeye• 1⁄4 cup tofu

Milk, Yogurt, and Cheese

Aim for 11⁄ 2 to 2 cups a day.Here are choices that equal 1 cup:• 1 cup cut up raw or cooked

fruit• 1 cup fruit juice• 1⁄2 cup dried fruit

Fruits

Aim for 6 to 7 ounces a day.Here are choices that equal 1 ounce:• 1⁄2 cup of cooked cereal• 1⁄2 cup cooked rice or pasta • 1 cup ready-to-eat cereal • 1 slice of whole grain bread• 1⁄2 small bagel or 1 small muffin

Breads, Cereals,Rice, and Pasta

Meat, Poultry, Fish, DryBeans, Eggs,and Nuts

Aim for 21⁄ 2 to 3 cups a day.Here are choices that equal 1 cup:• 1 cup cut up raw or cooked or

vegetables• 2 cups leafy salad greens• 1 cup vegetable juice

Source: USDA (www.usda.gov)

Choose dark green and orangevegetables as often as you can.

Choose whole grainfoods for at least

3 of your 6 choices.Choose fresh whole

fruits as often as you can.

If you choose to eat these foods, have avery small amount and not every day.

Regular Soda, Candy,Cookies, and Desserts

One serving is• 1 teaspoon vegetable, olive, or canola oil• 1 teaspoon tub margarine• 5 large olives or 1⁄8 avocado• 1 tablespoon low-fat mayonnaise • 2 tablespoons low-fat salad dressingHow much should you eat? You get most of the fat your body needs from

other foods you eat—so choose only a few extra servings ofthese heart-healthy fats each day.

Heart-healthyFats

What can I eat? “Your Healthy Food Guide” gives ideas about what kinds of foods are good for you.Remember, this is only a guide. Talk with your doctor or dietitian about making a meal plan just for you.

• If you are overweight, checkwith your doctor before youstart a physical activity program.

• Be active every day. Physicalactivity should be part of yourdaily life. Play sports, take P.E.or dance, or other exercise classes—check out your local Yfor some ideas. Get from place to place by walking or biking. Take the stairs whenever you can.

ú www.YourDiabetesInfo.org

How much should I eat? The amount of food you need to eat eachday varies with your age, sex, height, and activity level. The amounts in “YourHealthy Food Guide” are right for girls age 11 to 17 or boys age 11 to 14 who get 30to 60 minutes of physical activity each day. If you are a boy older than 14, or if youwant to enter your own height or activity level, visit www.mypyramid.gov.

more physically active?

Limit your screen time. Turn off the TV and get moving! Several studies have found that teens who watch a lot of TV have more body fat than those who watch TV less than two hours a day.

Try to cut some calories. If you cut 100 to 200calories a day, it can make a big difference.

If you: You could cut about:

Drink water instead of regularsoda or a sweetened fruit drink 150 calories

Eat a piece of fruit instead of acandy bar or a bag of chips 200 calories

Eat a small serving of frenchfries or share a big one 250 calories

Eat one half cup of sugar-free,nonfat pudding instead of regular ice cream

150 calories

Learn more!Check out…

Francine Kaufman, M.D., Head, Center for Diabetes, Endocrinology and Metabolism at Childrens Hospital Los Angeles and Janet Silverstein, M.D., Professor and Chief,

Pediatric Endocrinology, Department of Pediatrics, University of Florida, Gainesville, FL reviewed this material for technical accuracy.

National Diabetes Education Program for moreabout diabetes www.YourDiabetesInfo.org1-888-693-NDEP

American Diabetes Association for help to manage diabetes www.diabetes.org/planetD1-800-DIABETES (1-800-342-2383)

American Dietetic Association to find a dietitian near you www.eatright.org • 1-800-366-1655

Bam! Body and Mind website for help to stay healthywww.bam.gov

Children With Diabetes website for more about kidsand families with diabetes www.childrenwithdiabetes.com

MyPyramid.gov for more about healthy eating and being active www.mypyramid.gov

National Association for Health and Fitness thatpromotes physical activitywww.physicalfitness.org • 1-716-583-0521

National Diabetes Information Clearinghouse formore about diabeteswww.diabetes.niddk.nih.gov • 1-800-860-8747

President’s Council on Physical Fitness andSports that promotes physical activity www.fitness.gov1-202-690-9000

USDA Team Nutrition to make healthy food choices and stay active www.fns.usda.gov/eatsmartplayhardkids

VERB for cool and fun ways to be active every daywww.verbnow.com

WIN – Weight-control Information Network forweight control help • Take Charge of Your Health! A Teenager’s Guide to Better

Healthwww.win.niddk.nih.gov/publications/take_charge.htm1-877-946-4627

Special thanks to the teens who helped create this tip sheet

The U.S. Department of Health and Human Services’ National Diabetes EducationProgram is jointly sponsored by the National Institutes of Health and the Centers for Disease Control and Prevention with the support of more than 200 partner organizations. www.YourDiabetesInfo.org or 1-888-693-NDEP

Revised November 2007 NIH Publication No. 08-5295 NDEP-87

Try these healthy eating tips.• Take your time when you eat. It takes

about 15 minutes for your stomach totell your brain that you are full. So, wait15 minutes before eating second helpings.

• Do not skip meals. Eat breakfast, lunch, and dinner,plus a snack. You will have a ready supply of energy and not get too hungry.

• For breakfast, try one or two slices of whole graintoast with a tablespoon of peanut butter, a hard-boiled egg, or a piece of low-fat cheese, along with a glass of low-fat or nonfat milk.

• Make a sandwich with turkey or lean beef for lunch.Use mustard or a little low-fat mayonnaise.

• Snack on a small bowl of whole-grain cereal withlow-fat or nonfat milk and a piece of fruit.

• Don’t “super-size” it! Order smaller, kid-sized mealsand drink water or low-fat or nonfat milk. Share alarger meal with a friend.

• Fill up half of your plate with salad or vegetables.Use small amounts of low-fat salad dressing, mayonnaise, or margarine.

What’s in it for me?If you lower your risk for type 2 diabetes, you will:• have more energy • feel good about yourself• be healthy now and in the future

Take action now. Use the ideas in this tip sheet tostay healthy and lower your risk for type 2 diabetes.

Are studies being doneabout type 2 diabetes?Yes, studies are being done to learn ways to helpprevent and manage type 2 diabetes in kids andteens.

The SEARCH for Diabetes in Youth Study is finding out how many kids and teens have type 2diabetes. www.searchfordiabetes.org

The TODAY Trial is finding the best ways to treattype 2 diabetes in kids and teens.www.todaystudy.org

The HEALTHY Study is testing a program to lowerrisk factors for type 2 diabetes in middle school students.

www.YourDiabetesInfo.org

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Grain / Bread ☺ Whole wheat bread

☺ Cereal (with no sugar)

☺ Cereal bars (when you are on the go) (Quaker bars are ap-proved by WIC)

☺ Whole wheat pasta

Fruits / Vegetables ☺ Fruits— (fresh, frozen, or canned) (when buying canned

or bowls make sure they are light in syrup or own juice) ☺ Bananas, Apples, Oranges are always easy to

grab when on the go) ☺ Vegetables—fresh and/or frozen (when buying frozen

make sure they don't have any added spices) ☺ Lettuce romaine

☺ Tomatoes

☺ Baby spinach

☺ Cucumber

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☺ Baby Carrots (skinless)

☺ Buy Fruits and Vegetables that are in season!

☺ For example: Peaches, Plums, apricots, nectarines and tomatoes are summer fruits. Apples, Oranges, and grapefruits are less expensive in the winter. ☺ Go to the farmers market instead of the grocery store.

Protein / Meat / Meat Alternative ☺ Chicken Breast

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☺ Egg beaters

☺ Beans (Frozen are cheaper and have no sodium and additives)

Milk ☺ Milk (Skim or 1%)

☺ Yogurt (fat-free or not added sugar)

☺ Cheese (Fat free or reduced fat)

Alternatives ☺ Peanut Butter (make sure .. “No trans fat & No Hydrogenated

Oil”) ☺ Dried fruit

☺ Whole grain pretzels

☺ Oats

☺ Jell-o and/or pudding (sugar free)

☺ Sugar-free popsicles

☺ Raisins

☺ Granola

☺ Whole wheat pita or tortillas

☺ Nuts (make sure they are “original” no salt or any additives.)Tip: you might have availability to a pecan tree!

☺ Fruit bowls (make sure to check they are light syrup or own juice)

When Cooking use… ☺ PAM (depending on your cooking method)

☺ For seasoning use:

☺ Condiments and spices salt free. For example: Mrs. Dash all purpose

☺ Herbs. For example: Basil, Oregano, Garlic, Parsley, Rosemary, Thyme.

☺ Olive Oil

☺ Mustard

☺ Peeled tomatoes in can (make sure you read the label and pay attention to the salt content)

Alisa Pettry, MS, RD Daniel Preud’Homme, MD, CNS

Milena Torres, USA Health Ed. Intern The USA Pediatric Healthy Life Center

Grain / Bread

Fruits / Vegetables

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Milk

Alternative Snacks When Cooking use...

Shopping List



Grain / Bread

Fruits / Vegetables

Protein / Meat / Meat Alternative

Milk

Shopping List



Cooking...

Healthy Snacks

Shopping List



What Drinks Should I Get?

Instead of buying regular soft drinks and sweet tea get Sugar-free drinks and diet sodas. Tip: store brands are ok as long as they are sugar free!

Take an empty water bottle or your favorite sports bottle, rinse it thor-oughly and fill it with tap water. If you object to the chlorine taste, just keep the bottle in the refrigerator for at least 8 hours. The chlorine taste will disappear.



DON’T BUY BUY

Regular Coke/Soft Drinks Diet Drinks

Juice/ Juice Drinks Sugar Free Drinks

Candy/ Potato Chips Fresh, Frozen, or Canned Fruit

Canned Fruit in Heavy Syrup Canned Fruit in Own Juice or Light Syrup

Whole or 2% Milk 1% or Fat Free Milk

Regular Cheese Reduced Fat or Fat Free Cheese

What to Buy at the Grocery Store

DON’T BUY BUY

Regular Yogurt Reduced Fat or Fat Free Yogurt

Frozen Vegetables with Butter or Cheese Sauces

Frozen Vegetables without Butter or Cheese Sauces or Fresh Vegeta-

bles

Regular Canned Vegetables No Salt Added Canned Vegetables

Regular Canned Soup Low Sodium Canned Soup/Broth

Regular Salad Dressing Reduced Fat or Fat Free Salad Dressing

Regular Mayonnaise Light or Fat Free Mayonnaise

DON’T BUY BUY

Regular Sour Cream Reduced Fat or Fat Free Sour Cream

Sugar Sweetened Cereal Unsweetened Cereals with 3 grams of fiber per serving

White Bread Whole Wheat Bread with 2 grams of fiber per serving

White Rice Brown or Wild Rice

White Pasta/Fried Noodles Whole Wheat Pasta

Buttered Popcorn 94% Fat Free Popcorn

DON’T BUY BUY

Crackers Whole Grain Crackers

Regular Popsicles Sugar Free Popsicles

Regular Ice Cream Fat Free/Sugar Free Ice Cream

Regular Hot Dogs 94% Fat Free or Fat Free Beef or Turkey Hotdogs

Bacon Center Cut of Pork

DON’T BUY BUY

Regular Ground Turkey Meat Ground White Turkey Meat

70/30 Ground Meat Lean Ground Chuck or Round

Stick Butter, Lard, or Shortening Soft Tub Margarine or Vegetable Oil

Flour Tortillas Corn or Whole Wheat Tortillas

Canned Ravioli/Spaghetti 99% Fat Free Canned Ravioli/Spaghetti


The USA Pediatric Healthy Life Center

One Hundred Calorie

Snacks Rice Cake 2 Popcorn (94% Fat Free) 3 cups or 1 mini bag Apple, Orange, Peach 1 medium Pear, Plum, Nectarine 1 medium Banana 1 small Grapes 1 cup Berries/Melon 1 cup Applesauce (sugar free) ½ cup Fruit Cup 1 (4 oz) Raisins 2 Tbsp (1 oz) McDonalds Apple Slices 1 package Light/Low Fat Yogurt 8 oz Ice Cream 3 oz Wheat Thins 8 Triscuts 10 Graham Crackers 3 squares Fruit Roll-up 1 Chewy Fruit Bar 1 Fruit Snacks 1 pouch Animal Crackers 8 Special K Cereal Bar 1 Sugar Free Pudding ½ cup Vanilla Wafers 5 Sugar Free Hot Chocolate 1 package 100 Calorie snacks 1 package Milk Skim or 1% 1 cup Gummy Bears 10

Free Foods

Water, Sugar Free Drinks, Propel, Power aid OPTION, sugar free Jello, sugar free gum, sugar free popsicles, Cucumber slices, Tomato, Lettuce, Peppers green or red,

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Eating Healthy for Less: Tips to Stretch Your Food Dollar

Planning Your List: • Take time to plan your meals for the week and make a grocery list. • Make sure to check you kitchen cabinets and refrigerator when making your grocery list so you can plan meals with

items already available. • Plan meals with fruits and vegetables that are in season or use frozen vegetables. • Plan meatless meals a few times a week using beans, eggs, or peanut butter as a main dish. • Read the paper weekly and on Sunday for sales at your grocery store. Shopping Tips: • Grocery shop once a week. Don’t make a quick trip to the store because it is hard to only purchase a few items. • Stick to your shopping list and don’t shop when you are hungry because you will spend a lot of money on extra food. • Pick the grocery store near you with the best prices for the foods you buy —Remember that convenience stores

often charge more. • Shop a local farmers’ market—Fruits and vegetables tend to be cheaper and fresher. Remember to plan your meals

with produce that is in season. • Shop when you are not in a hurry. Take time to compare prices and buy the cheapest.

For example– Would it be better to buy the food fresh or frozen? • Compare store brands to name brands. Usually the store brand is cheaper and the quality and taste are the same. • Compare the unit price of food items to find the best value. Remember that the largest container is not always the

cheapest. • Avoid buying larges amounts of foods that spoil quickly— This is a waste of money. • Buy larger sizes of staple foods if you have the storage space and the extra money. • Buy family packs of lean meats, poultry, and low-fat cheese and divide them into servings, freeze them, and use

them as needed. • Buy regular brown rice. It is a better buy than instant, quick cooking rice or fancy rice blends. • Buy quick cooking oatmeal rather than single serving instant oatmeal. Cooking Tips: • Buy a whole chicken and use it for more than one meal. • Stretch ground meat by adding bread crumbs, oatmeal, or tomato sauce. • Use nonfat dry milk in place of low-fat milk for drinking and cooking. Chill milk before

drinking for better taste. Store the powdered milk in the freezer in a plastic sealable bag. • Make casseroles with leftovers. • Make salads using leftover vegetables, fruits, and meats.

Adapted from the Alabama Cooperative Extension Services Alisa Pettry, MS, RD

Daniel Preud’Homme, MD, CNS The USA Pediatric Healthy Life Center

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