A modest uptick in the amount of fruit and vegetables you eat can help ward off type 2 diabetes, according to a study published online July 8, 2020, by The BMJ. From a much larger study involving some 340,000 people from eight European countries, scientists selected 9,754 participants who were newly diagnosed with diabetes over a decade. Researchers compared the fruit and vegetable intakes of these people to those of about 13,000 participants who remained diabetes-free during the study period. Researchers also measured blood levels of seven key plant-derived nutrients, including vitamin C and brightly colored antioxidant pigments called carotenoids. People with the highest intakes of fruit and vegetables and the highest blood levels of the plant-derived nutrients were 25% to 50% less likely to get diabetes during the study period, compared with those who ate the least of these food groups or had the lowest nutrient levels. Even better, it didn’t take a whole lot of extra green, red, yellow, and orange on the plate to make a dent in diabetes risk. The equivalent of only two-thirds of a medium apple or just over one-third of a cup of mixed fruit each day offered protection.
A modest uptick in the amount of fruit and vegetables you eat can help ward off type 2 diabetes, according to a study published online July 8, 2020, by The BMJ. From a much larger study involving some 340,000 people from eight European countries, scientists selected 9,754 participants who were newly diagnosed with diabetes over a decade. Researchers compared the fruit and vegetable intakes of these people to those of about 13,000 participants who remained diabetes-free during the study period. Researchers also measured blood levels of seven key plant-derived nutrients, including vitamin C and brightly colored antioxidant pigments called carotenoids. People with the highest intakes of fruit and vegetables and the highest blood levels of the plant-derived nutrients were 25% to 50% less likely to get diabetes during the study period, compared with those who ate the least of these food groups or had the lowest nutrient levels. Even better, it didn’t take a whole lot of extra green, red, yellow, and orange on the plate to make a dent in diabetes risk. The equivalent of only two-thirds of a medium apple or just over one-third of a cup of mixed fruit each day offered protection.
A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.
A physical therapist answers your questions
If you suffer from back pain, youโve probably heard that strengthening your core can bring you some relief. But is this always true? And if so, how do you do it? We spoke with Cleveland Clinic physical therapist Patti Mariano, DPT, to find out.
Q: What is your core?
When most people think about the core of the body they think of the abdominal or six-pack area just below the ribs. While the abdominal muscles are an important part of the core, we consider other areas important, too.
Your core includes:
Front abdominal muscles โ the rectus abdominis
Muscles along the side of your body โ the internal and external obliques
A deep muscle that wraps around the front โ the transverse abdominis
Muscles in your back that are located between your spine bones and run along your spine โ the erector spinae and multifidi
Your core also includes the diaphragm and muscles of the pelvic floor. I also consider the gluteal muscles as core muscles.
Q: What is the relationship between core strength and back pain?
Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures, including ligaments โ the tissue that connects bone to bone โ as well as the spinal bones or discs, which lie between the spinal bones, for stability, which can cause pain.
But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.
Q: What are some exercises for the core that can help with back pain?
Here are my top five:
Side plank โ Sit on the floor with your right hand below your right shoulder and feet stacked. Lift your body, keeping your legs long, abdominals engaged and feet stacked. Hold. Repeat on the other side. You can modify this pose by dropping your bottom knee to the floor for extra support.
Plank โ Kneel on all fours. Pull in your abdomen and step your feet behind you until your legs are straight. Keep your hands directly under your shoulders and your neck straight. Hold your abdomen and legs tight and avoid letting your lower back sag. Hold and breathe for 30 seconds. You can modify this pose by lowering your knees.
Bird dog โ Kneel on all fours. Reach one arm out in front of you, draw in your abdomen, and extend the opposite leg long behind you. Repeat on the other side.
Scissors โ Lie on your back with your arms at your sides and legs pointed straight into the air above your hips. Press your lower back into the mat and tighten your abdomen. Lower your right leg until itโs a few inches from the floor. Raise your right leg up and begin lowering your left leg the same way. Continue switching right and left.
Upward dog โ Lie face down with head slightly lifted and hands palm-down under your shoulders. Point your toes. Exhale, then press through your hands and the tops of your feet and raise your body and legs up until your arms are straight and your body and legs are off the ground. Keep your neck relaxed and long and thigh muscles tight as you hold and breathe.
For the plank exercises, start by holding them for 15 seconds to 30 seconds. For bird dog and scissors, try three sets of eight or 10 repetitions. For upward dog, do one set of 10 repetitions.
Q: Can you injure your back by trying to strengthen your core?
Any exercise performed incorrectly, whether it is core-strengthening or otherwise, has the potential to cause discomfort.
Twisting exercises or even incorrectly completing the exercises cited above can cause pain in the low back. But itโs highly unlikely that one repetition of an exercise will seriously harm your body, unless itโs an exercise using a very heavy weight.
The best way to keep your body safe is to listen to body cues such as pain during and immediately after an exercise, and the next day after exercising.
Q: When should you talk to a doctor about your back pain?
If any of the following is going on you should consult with your doctor:
Your pain has been going on for longer than a month, despite resting from activities that make it worse.
Your pain is getting worse.
Your pain wakes you from sleep.
Your pain is in your low back but also is going down one or both of your legs.
You notice that one leg is becoming weaker than the other.
Q: Where should you turn if you want help in creating a plan to address back pain?
Physical therapists train as musculoskeletal experts โ they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.
Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely.
The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.
If youโre planning to start an exercise program and wondering where to begin, start with your core first, says physical therapist Brittany Smith, DPT. People often think of the core muscles as being the abdominal muscles, but the core includes the muscles in the abdomen, back and hips, all working together as a group.
โThe core muscles provide stability for the entire body as it moves,โ says Smith. โThese muscles are activated when you stand up, turn, bend, reach, twist, stoop and move in most other ways. Everything starts with your core.โ
Strong core muscles help you maintain good posture, while weak ones can lead to slouching and slumping. Poor posture can be a cause of aches and pain, especially in the back.
Getting started with your core
To get your core muscles in shape, you need to exercise.
โOur bodies were made to move, so any physical activity is really important,โ says Smith.
She recommends these specific core-strengthening exercises below.
The first one engages the deep muscles in the abdomen, called the transverse abdominis. โThese muscles help hold us in a better position to stabilize our core, thereby stabilizing our arms and legs,โ says Smith.
โThe more you work on these muscles, the more it will become second nature to hold these muscles tight when youโre lifting grocery bags, doing yard work or any other kind of physical activity,โ says Smith. This will help support your body.
Other muscles that tend to be weak are the gluteus maximus in the buttocks, and the gluteus medius and gluteus minimus on the side of the hip. The bridge and clamshell exercises can help strengthen these muscles.
Smith emphasizes that getting the proper position of these exercises correct is more important than the number of repetitions you do. โItโs better to take your time, maybe do fewer reps, but with better quality,โ she says. For that reason, it can be helpful to have the guidance of a physical therapist to get started.
Move on from the core
Core exercises are the starting point of overall fitness because you need to hold those muscles engaged while you strengthen other muscles, such as the biceps in the arms or the quadriceps in the legs.
Smith suggests setting short-term goals (for about a month) and then more long-term goals. Once you have achieved short-term goals, such as getting around more easily, add other types of weight-training or resistance exercises to build muscle elsewhere.
With any exercise you do, always listen to your body, warns Smith. If you have pain other than muscle burn, take it easy. Reduce the number of repetitions, the weight or the duration of the exercises. Then build up gradually. โYou donโt have to be in pain to make gains,โ she says.
Beginner exercises for core strength
For each of the following, work up to one to two sets of 10 to 15 repetitions once a day.
Abdominal bracing
Lie on your back with your knees bent and feet flat on the floor. Contract your abdominal muscles, and press the arch of your back down toward the floor, pulling your belly button toward your spine. Hold for 5 to 10 seconds. Make sure your lower back stays flat on the floor. Relax and repeat.
Bridge
Lie on your back with your knees bent and feet flat on the floor with your arms at your sides. Squeeze your abdominal and buttocks muscles, push your heels into the floor and slowly lift your buttocks and hips off the floor. Keep your back straight. Hold for 5 to 10 seconds.
Clamshell
Lie on your side with knees bent in line with your hips and back, draw up the top knee while keeping contact of your feet together as shown. Donโt let your pelvis roll back during the lifting movement. Hold for 5 seconds.
Try our lighter carrot cake, which the entire family will love. It has just the right texture, like a slightly sweetened, light corn bread. Itโs great on its own or with a dollop of frozen whipped topping or nonfat ice cream.
Ingredients
No-stick baking spray with flour
1 cup unbleached all-purpose flour
ยฝ cup whole wheat flour
ยฝ cup granulated sugar substitute
ยผ cup packed light brown sugar
ยผ cup nonfat dry milk
1 ยผ teaspoons baking soda
1 ยฝ teaspoons baking powder
1 teaspoon ground cinnamon
ยผ teaspoon ground cloves
ยฝ teaspoon ground nutmeg
ยฝ teaspoon ground allspice
ยผ cup canola oil
1 large egg
ยพ cup egg substitute
1 ยฝ cups finely grated carrots
2 tablespoons finely chopped walnuts
2 tablespoons golden raisins ย
One 6-ounce can unsweetened crushed pineapple, drained ย
2 tablespoons confectionersโ sugar, optional
Directions
Preheat the oven to 350ยบF. Coat a 10-inch pan with baking spray.
Sift the white and whole wheat flours into a large bowl. Add the sugar substitute, brown sugar, dry milk, baking soda, baking powder and spices. Stir to mix well. Using the medium setting of an electric mixer, beat in the oil, egg and egg substitute until the batter is smooth. Fold in the carrots, walnuts, raisins and pineapple.
Spread the batter into the prepared pan and bake for 30 minutes, until a toothpick inserted in the center of the cake comes out clean. Cool in the pan. Remove the outer ring of the pan and sift confectionersโ sugar over the top, if desired. Serve at room temperature.
Dietitianโs Note: Never has carrot cake tasted so good, and been so guiltless! When compared to traditional carrot cake with icing, you save 180 calories, 12 grams of fat, and 4 grams of saturated fat.
Who doesnโt want a healthy immune system? (Raise your hand. No one?) But did you know the role your diet plays in keeping it in top shape to protect you from toxins and infections? Sadly, too many of us donโt eat enough of the fresh fruits, vegetables and other foods we need to keep ourselves healthy year-round. Healthy foods provide many substances including vitamins and minerals to keep us strong and healthy. You canโt just eat an orange or grapefruit or pop a vitamin pill and expect one quick burst of vitamin C to prevent a cold and to boost your immune system. โA truly healthy immune system depends on a balanced healthy diet over time,โ says registered dietitian Maxine Smith. โItโs like training for a battle and preparing your body ahead of time so it can through a good punch when attacked by viruses, bacteria and toxins. Other lifestyle practices such as regular exercise and good sleep will better prepare you for the battle.โ With some exceptions, itโs best to get your vitamins and minerals from your food rather than in pill form. Smith shares some tips for some of the top vitamins and minerals your immune system needs to perform:
1. Vitamin C Vitamin C may help prevent infections or shorten their stay. Citrus fruits are a standout, but did you know there are other good sources? Itโs true! Smith recommends the following: Spinach. Kale. Bell peppers. Brussels sprouts. Strawberries. Papaya. Fun fact: vitamin C is in so many foods that most people may not need to take supplements unless a doctor advises it. Consult with your doctor before taking any vitamin C supplements
2. Vitamin E Like vitamin C, vitamin E can be a powerful antioxidant that helps your body fight off infection. This important vitamin โ part of nearly 200 biochemical reactions in your body โ is critical in how your immune system functions. To get your vitamin E, think high-fat plant foods such as: Almonds. Peanuts/peanut butter. Sunflower seeds. Oils such as sunflower, safflower, and soybean oil. Hazelnuts.
3. Vitamin A#
Vitamin A is an infection-fighter and comes in two forms: preformed such as in animal foods such as fish, meat and dairy or from plant carotenoids. Tuna is a great source of preformed vitamin A. When it comes to carotenoids, go colorful: Carrots. Sweet potatoes. Pumpkin. Butternut squash. Cantaloupe. Dark green leafy vegetables.
4. Vitamin D Known as the sunshine vitamin, itโs one of the most important and powerful nutrients for supporting the immune system. Food sources are limited but include: Salmon. Mackerel. Tuna. Sardines. Vitamin D fortified like milk, orange juice and cereals. In general, itโs best to get most of your vitamins from food, but vitamin D may be the exception to that rule. Talk with your doctor to find out if you need a supplement.
5. Folate/folic acid Folate is the natural form and folic acid is the synthetic form, often added to foods because of its health benefits. To get more folate, add more beans and lentils to your plate on a regular basis, as well as leafy green vegetables. Avocado is another tasty source. You can also get folic acid in fortified foods (check the label first). Enriched pasta. Enriched bread. Enriched rice.
6. Iron Iron, which helps your body carry oxygen to cells, plays a part in many of the immune system processes. It comes in different forms. Your body can more easily absorb heme iron (aka iron from animal products), which is abundant in: Red meat (limit to smaller amounts and less often). Chicken. Turkey. Canned sardines. Oysters. Clams. Mussels. Canned light tuna. If youโre a vegetarian, have no fear. You can still find iron in: Beans. Broccoli. Kale. Iron-fortified cereals.
7. Selenium Selenium seems to have a powerful effect on the immune system being important for preventing infections. Animal foods are the best sources, with the exception of Brazil nuts, that offer a whopping greater than 100% daily value in one nut. However, too much can be a problem, so keep to no more than one to two of these in a day. Look for selenium in: Seafood (tuna, halibut, sardines). Meat and liver. Poultry. Cottage cheese.
8. Zinc Zinc is needed for the production of new immune system cells. Itโs found primarily in animal foods but can be also found in some vegetarian food like. Oysters. Crab. Lean meats and poultry. Baked beans. Yogurt. Chickpeas. Choose frozen when you canโt get fresh Depending on where you live and what time of year it is, you canโt always get your hands on high-quality fresh produce. Keep in mind that buying frozen is a good option and can be quite convenient in our time-crunched world. Frozen food can still boost your immune system. โManufacturers freeze frozen fruits and veggies at โpeakโ ripeness, which means theyโll pack a similar nutritional value as their fresh counterparts,โ she says. โJust choose plain frozen foods rather than those with added sugars or sodium.โโ Facebook Twitter
A modest uptick in the amount of fruit and vegetables you eat can help ward off type 2 diabetes, according to a study published online July 8, 2020, by The BMJ. From a much larger study involving some 340,000 people from eight European countries, scientists selected 9,754 participants who were newly diagnosed with diabetes over a decade. Researchers compared the fruit and vegetable intakes of these people to those of about 13,000 participants who remained diabetes-free during the study period. Researchers also measured blood levels of seven key plant-derived nutrients, including vitamin C and brightly colored antioxidant pigments called carotenoids. People with the highest intakes of fruit and vegetables and the highest blood levels of the plant-derived nutrients were 25% to 50% less likely to get diabetes during the study period, compared with those who ate the least of these food groups or had the lowest nutrient levels. Even better, it didn’t take a whole lot of extra green, red, yellow, and orange on the plate to make a dent in diabetes risk. The equivalent of only two-thirds of a medium apple or just over one-third of a cup of mixed fruit each day offered protection.
