Endocrinology (including Diabetes)/Cantaloupe and Excercise

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QUESTION: Hi Sheri,

Thank you for taking my question[s]!

First off - I've heard/read that although it's best for type 2 diabetics to stay off carbs as much as possible, cantaloupe is okay. When i researched the nutrition facts on cant. however, I see that it too has plenty of carbs. Can you guide me on this please? Is it fine, no problem at all or best eaten in severe moderation or what?

Second question - I exercise hard in order to keep my weight and cholesterol under control. Mostly biking but I'm trying to work some weight training into my schedule too. I read that it is best to eat some carbs when exercising because it'll help build the muscles etc. I usually don't have many carbs at all on an average day or when I do, I combine them with some nuts to temper the insulin reaction. What's your opinion on eating carbs when exercising?

Third Question - Generally my lunch is a soup of some sort [vegetable, onion etc] and salad with a bit of fish etc. Dinner is also lots of veggies, some protein etc. For breakfast I eat a small amount of grape nuts cereal together with a few spoonfuls of ground nuts and milk. this keeps me going strong until lunchtime. In your opinion, is that too heavy on the carbs?

Thaks so much. I hope I didn't take too much of your time but I'm really trying my best to do this right.

ANSWER: Mark,
  All fruit has carbohydrates as the main source of calories.  What makes some fruits better than others to eat when you're trying to manage blood glucose levels is their glycemic effect, that is, how quickly and how much they raise your blood glucose.  Cantaloupe has a fairly low glycemic index (or GI; see www.glycemicindex.com), as do most berries.  You also want to consider the total carbohydrate content of whatever you eat (number of carbs per serving).  Some fruits are worth avoiding, such as pineapple and watermelon, while others have a minimal impact on blood glucose levels.
  As far as eating carbs for exercise, it doesn't build muscles, but it does help you replace any stored carbs (muscle glycogen) you used more effectively between workouts.  It's find to eat a small amount of extra carbs either right before or within 1-2 hours after you exercise.
  The only problem I see with eating Grape Nuts for breakfast is that they are deceptively dense in carbohydrates and morning is the time of day when your body is most insulin resistant.  Having you measured the amount to calculate out the actual number of carbs?  Usually your body can handle carbs better later in the day compared to in the AM.  To see whether it's working for you or not, check your blood glucose before and about one hour after breakfast and see how much they make your BG spike.  If it goes above about 180 mg/dl, it's probably more than your body can handle at that time of day.
  Sheri

---------- FOLLOW-UP ----------

QUESTION: Hi - thank you for your answer.

One more question - What I do with the Grape Nuts is mix them with about three tablespoons of ground nuts and all I take of the grape nuts is about half a cup of them. I had hoped that the nuts would offset somewhat the glycemic effect of the grape nuts. Is that okay?
Also, if I decide not to use Grape Nuts [which I chose because they're whole grain and no sugar added] what else would you recommend? I'm open to trying something else so long as it's not too difficult to prepare and will keep me full or sated for a about 3-4 hours

Thank you again

Answer
Mark,
  The nuts don't directly keep the Grape Nuts from being digested; rather, they make you feel fuller without a lot of extra carbs.  It only offsets the effect because you eat a lower total number of carbs.  A half cup still has 48 grams of carbs (including 7 grams of fiber, so only really 41 grams that affect blood glucose levels).  Again, check your BG and see what effect it has on you.  As far as cereals go, Grape Nuts aren't bad; they're just carb-dense.  Sheri

Endocrinology (including Diabetes)

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Sheri Colberg, PhD

Expertise

I am an exercise physiologist with a PhD who specializes in diabetes--as such I CANNOT answer general questions about other endocrine problems as I am neither an expert in all areas of endocrinology nor am I a medical doctor. My expertise lies in answering questions about diabetes (of any type) and physical activity, so please limit your questions to those areas. I can help you if you want to begin exercise or if you're already a diabetic athlete, and I am prepared to respond to questions about physical activity to which even your diabetologist may not know the answer. I can give suggestions about changes in your diabetic medications that differing types and intensities of exercise may necessitate, but I will have to refer you to your regular health care team to get final approval to make such changes. I can also answer questions about physical fitness, exercise metabolism, prediabetes reversal, and prevention of type 2 diabetes and diabetic complications.

Experience

I have both personal and professional experience in the areas of diabetes and exercise/physical activity. On a personal level, I have had type 1 diabetes since 1968, and I have been an avid exerciser since I was a child. Professionally, I have been conducting clinical studies on diabetes and exercise since 1992, largely with funding from the American Diabetes Association. I am also the author of 8 books related to diabetes, exercise, and more: The Diabetic Athlete (2001), Diabetes-Free Kids (2005), The 7 Step Diabetes Fitness Plan (2006), 50 Secrets of the Longest Living People with Diabetes (2007), The Science of Staying Young (2007), Matt Hoover's Guide to Life, Love, and Losing Weight (2008), Diabetic Athlete's Handbook (2009), and Diabetes? No Problema! (2009).

Organizations
I am a Fellow of the American College of Sports Medicine, a professional member of the American Diabetes Association (and professional volunteer for the ADA), and a former member of the Board of Directors of the Diabetes Exercise & Sports Association.

Publications
I have published research and review articles in the following journals and magazines: Diabetes Care, Diabetes, Journal of Diabetes & Its Complications, Diabetes Self-Management, Medicine & Science in Sports & Exercise, Journal of Applied Physiology, The Physician and Sportsmedicine, Journal of Clinical Investigation, International Journal of Obesity, FASEB Journal, The Diabetes Educator, Journal of Physical Education, Recreation, and Dance, Clinical Exercise Physiology, Clinical Diabetes Reviews, Insulin, ACSM's Health & Fitness Journal, Biomechanics, On the Cutting Edge, Diabetes Technology & Therapeutics, Microvascular Research, Drug Benefit Trends, ACSM Certified News, Diabetes Health, SportEX Health, Diabetes Focus, Diabetes In Control, dLife-For Your Diabetes Life, Pediatrics for Parents, and My TCOYD (Taking Control of Your Diabetes) Newsletter. I have also been interviewed in myriad other magazines, such as Men's Health, Men's Fitness, Diabetes Forecast, Countdown Magazine, Joe Weider's Muscle & Fitness, Health, Tidewater Parent, Barron's News, Diabetes New Day, and Newsweek International.

Education/Credentials
I have an undergraduate degree (1985) from Stanford University, a Master's degree in exercise physiology (1987) from the University of California, Davis, and a Ph.D. (1992) from the University of California, Berkeley, in the same field. I also spent two years in an NIH-funded postdoctoral research position in endocrinology (studying obesity, diabetes, metabolism, and exercise) at the University of Pittsburgh School of Medicine (1993-1994).

Awards and Honors
Fellow, American College of Sports Medicine (FACSM) - 1996 Old Dominion University Darden College of Education Young Investigator Grant Award 2003 Honor Society of Phi Kappa Phi, Old Dominion University Chapter 2004-Present Great Women of the 21st Century by the American Biographical Institute 2005 Edition Old Dominion University Darden College of Education Largest Research Grant Award 2006 Old Dominion University Darden College of Education Publications Award (for greatest number) 2006 Saint Louis University, The Max K. Horwitt Memorial Lecture Distinguished Lectureship Award 2008 Old Dominion University Darden College of Education Publications Award 2009 Old Dominion University Darden College of Research Grants Award 2009

Past/Present Clients
I have consulted for numerous groups, including Can-Am Care, Numera|Social, California Commission on Peace Officer Standards and Training(about candidates with diabetes), Animas Corporation (an insulin pump company), Therasense, Inc. (makers of the Freestyle blood glucose meters), Council of Healthcare Advisors, and the City of Chesapeake (Virginia) Health Department.

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