Posted in Christmas, food, Health, news, pets, thanksgiving

What Your Pets CANNOT Eat This Holiday Season

ABOVE: SHAKEY-BOO TAKING ADVANTAGE OF DISTRACTED HOSTS

The holidays are coming and so are the in-laws.  So to avoid being outnumbered at the dinner table, we invite our pets.  But can pets eat table scrapings and leftovers from Thanksgiving and Christmas?

Let’s look at what they can and cannot eat.

 

Dogs

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According to the American Kennel Club, dogs can eat the following (in moderate amounts):

  • Turkey, Chicken, Beef (remove all bones so they don’t get swallowed and perforate the gut)
  • Ham
  • Shrimp
  • Salmon
  • Eggs
  • Cheese
  • Peanut Butter
  • Bread (with no raisins)
  • Popcorn
  • Corn
  • Honey

Avoid the following in dogs:

May be toxic; cause nausea, vomiting and diarrhea; electrolyte abnormalities; kidney damage; pancreatitis due to high fat content, or intestinal obstruction

  • Onions
  • Garlic
  • Chives
  • Raw Dough
  • Avocado
  • Raisins
  • Grapes
  • Chocolate
  • Cinnamon
  • Ice cream
  • Almonds
  • Macadamia nuts
  • Alcohol
  • Nutmeg
  • Mushrooms
  • Caffeine
  • Coconut
  • Energy drinks
  • Fatty/fried foods and even the fat trimmings
  • Artificial Sweeteners such as Xylitol

And watch their portions. They will eat and eat and eat and won’t keep a tally on what grandma, nephew and the neighbors threw at him.

 

Cats

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Fluffy or Snappy (above) can eat – but again only in moderation:

  • Meat
  • Fish
  • Grains
  • Vegetables (though many stick their nose up at it)
  • Eggs
  • Butter

Avoid similar foods as with dogs due to toxicity and also (according to Vetsnow)

  • Alcohol
  • Raw fish and eggs
  • Dairy products
  • Coffee, tea and energy drinks

 

Fish

fish

Yes, some will bring Nemo to Holiday dinner.

It appears fish can eat many types of meat and vegetables, scrambled eggs and even cooked rice but be careful of toxins, fats and cooking oils.

Parakeet

parakeet

I don’t have any of these and if I did, I doubt I’d share my turkey with it.  But according to pethelpful.com, many fruits, vegetables, breads and nuts (chopped up without shell) can be eaten by birdie.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

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Posted in food, Health, news

Turkey Related Salmonella Poisoning Sickens 164, Kills 1

The CDC has reported over 164 people have been sickened with Salmonella being linked to raw turkey.

Over 35 states are currently affected but no specific product has been identified.  Suspected sources include ground turkey, turkey patties, whole turkeys, live turkeys and turkey pet food.

The CDC reports the following:
  • Since the last update on July 19, 2018, 74 more ill people were reported, bringing the total to 164 ill people from 35 states.
  • Sixty-three people have been hospitalized.
  • One death was reported from California. Questions about the death should be directed to the California Department of Public Health.
  • Illnesses in this outbreak started from November 20, 2017 to October 20, 2018.
  • Epidemiologic and laboratory evidence indicates that raw turkey products from a variety of sources are contaminated with Salmonella Reading and are making people sick.
  • The outbreak strain of Salmonella Reading has been identified in various raw turkey products, including ground turkey and turkey patties. The outbreak strain has also been found in raw turkey pet food and live turkeys, indicating it might be widespread in the turkey industry.
  • A single, common supplier of raw turkey products or of live turkeys has not been identified.
  • CDC and USDA-FSIS have shared this information with representatives from the turkey industry and asked about steps that they may be taking to reduce Salmonella contamination.

Symptoms of Salmonella poisoning include fever, chills, rash, diarrhea and stomach cramps within 12-72 hours after exposure. The illness can last 4-7 days, although most people will recover without treatment.

Why is food borne illness on the rise?

Multiple issues could be playing a role.

  1. Fresh produce is not cooked like meat and can therefore harbor more germs
  2. Preservatives, used in fast food, help to deter pathogen growth, and more people are shying away from fast food than in the past, opting for “fresh”, healthier options.
  3. On-the-go produce may not be washed after packaging due to a false sense of security that the vegetables are “clean.”
  4. As our population ages, and as more people suffer from immunocompromising disease such as diabetes and cancer, they may be more susceptible to food borne illness.
  5. Our gut microbiome has changed as our diets have shifted to food with more preservatives, hence possibly being less resilient to new pathogens that enter.
  6.  In regards to the ground turkey, it is not the same as ground beef and leaving the patties pink in the center mean you are consuming raw poultry. Turkey meat may need to cook longer until no pink is seen and core temperature is at least 165 degrees for at least 15 seconds
  7. We’re less strict about cleaning than we used to be.  Counter tops used to be bleached and scrubbed for longer periods of time than we do now-a-days with antimicrobial wipes.

Therefore be diligent about cleaning counter tops, cook your food thoroughly, wash produce before eating and be aware of any reported recalls.

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in energy drinks, food, Health, news

Energy Drinks Can Increase Risk of Heart Attack Within 90 Minutes

A study from the University of Texas finds the consumption of energy drinks to have negative effects on the cardiovascular system by narrowing blood vessels that carry oxygenated blood as soon as 90 minutes.

Vessels that supply the heart, which may already be narrowed due to atherosclerosis, could narrow even more.

hdlcholesteroltreatments

Moreover the restriction of blood flow to vital organs implies the brain may not receive the optimal circulation it needs.

How dangerous are energy drinks?

The study was conducted by scientists who looked at the endothelial lining of blood vessels in 44 healthy non-smoking students and found within 90 minutes of drinking a 24 oz energy drink the vessel dilation dropped from 5.1% in diameter to 2.8% in diameter.

Now energy drinks contain various levels of caffeine, as explained below.  But they also contain taurine, sugar, vitamins and other ingredients. This study did not look specifically at caffeine but energy drinks, so the authors can’t specify what’s the culprit.

Demi Moore – Maybe Energy Drinks Caused her Tooth Loss

Last year, however, a South Carolina high school student collapsed in class and later died from allegedly consuming an energy drink.  The coroner’s report, revealed cited caffeine as the cause.  The caffeine induced a cardiac arrhythmia, abnormal heart rhythm,  and 16-year old Davis Allen Cripe tragically died within an hour.

What’s shocking is the amount of caffeine he ingested was not very high.  According to Richland County Coroner Gary Watts, Cripe drank, within a two-hour period, a large Mountain Dew, an energy drink, and a cafe latte from McDonalds. The teen had no medical problems or family history of heart issues.

A large Mountain Dew contains 54 mg per 12 fluid oz.  So a 20 oz drink would be close to 100 mg caffeine.

Energy drinks, depending on the brand, contain approximately 80 mg of caffeine per can.

A cafe latte from McDonalds, medium size, contains 142 mg of caffeine.

This in total would equal approximately 320 mg of caffeine ingested within a two-hour period.

The lethal dose of caffeine in adults range from 150-200 mg/ kg body weight.  So a 70 kg adult could consume a toxic level of caffeine at 10 grams (10,000 mg).

So 320 mg of caffeine is well below the toxic level.  But what caffeine could do could be the more dangerous part.

Caffeine has been known to induce arrhythmias.  It’s a stimulant, hence it can affect the heart’s electrical conductivity that manages the organ’s pumping  action.  Once the electricity is disrupted, the heart muscle fails to have a predictable, rhythmic stimulation, hence cannot pump effectively.

Caffeine also causes vasoconstriction, so blood flow to the heart could be compromised, potentially inducing a heart attack.

In 2014, researchers from Barcelona found energy drinks to be linked to rare cases of heart attack and arrhythmia.

A cup of coffee averages 95mg of caffeine whereas an energy drink contains 80mg.  But the latter is consumed much quicker than a hot cup of Joe that needs to be sipped, hence the consumer takes in a larger load of caffeine in a shorter amount of time.  This could be too much too fast for the heart.

The following is a chart of average caffeine content in common drinks:

image.jpg

Image from Business Insider

 

I can’t convince everyone to reach for a piece of broccoli rather than an energy drink when in need of a boost, but at the very least we should deter use by children and teens, and educate those with vulnerable hearts, blood pressure, diabetes, kidney and liver issues that an energy drink may not be the wisest beverage choice.

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

 

Posted in food, Health, news

Drug-Resistant Salmonella Sickens 92 Across 29 States

The CDC has reported 92 people, 21 of whom needed hospitalization, after eating chicken tainted with an antibiotic resistant form of Salmonella.

Fortunately, no deaths have been reported.

Experts found the bacterial strain of Salmonella infantis on various raw chicken products.

No discrete source, or brand of chicken, has been identified or named by the CDC.

For treatment, the CDC recommends the following:

Common first-line oral antibiotics for susceptible Salmonella infections are fluoroquinolones (for adults) and azithromycin (for children). Ceftriaxone is an alternative first-line treatment agent.

Salmonella is commonly associated with raw poultry, as well as eggs, and cooking thoroughly until the internal temperature reaches 165 degrees is recommended prior to cooling and consuming.  Moreover washing kitchen counters and cookware that touched the raw chicken is paramount to avoiding contamination by Salmonella.

 

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SALMONELLA:  IMAGE FROM THE CDC

 

Symptoms of salmonella poisoning include fever, chills, rash, diarrhea and stomach cramps within 12-72 hours after exposure. The illness can last 4-7 days, although most people will recover without treatment.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in food, Health, medications, news

Can Heartburn Drugs Raise the Risk of Osteoporosis?

This week a study revealed the use of Proton Pump Inhibitors (PPI’s) can increase the risk of hip fractures in dialysis patients by 20%.

As opposed to being forms of calcium carbonate, such as acid neutralizers such as Tums, or H2 (Histamine H2 Antagonist) blockers such as Pepcid and Zantac, the PPI’s reduce stomach acid production from the start.  They’re sold under the brand names of Prilosec, Prevacid, Protonix and Nexium.  They’re popularity has been skyrocketing over the last two decades and have become a mainstay treatment for multiple gastrointestinal issues including ulcers.

Researchers from Baylor College of Medicine found in their study, 75% of dialysis patients who suffered a hip fracture, took a PPI within the preceding three years.

Researchers have long debated if PPI’s can cause osteoporosis or thinning of the bones.

A Canadian study done in 2008 found 7 years of proton pump inhibitor use to raise the risk of osteoporosis-related fractures of the hip, wrist and spine.

Anderson et al wrote in the July 2016 issue of Current Opinion in Rheumatology stated the following:

The use of PPIs is a risk factor for development of osteoporosis and osteoporotic fractures. However, as the direct pathogenesis remains unclear, specific points of intervention are lacking, other than being vigilant in regard to the indication for prescribing PPIs and to use the lowest effective dose where PPIs cannot be avoided.

 

Foods that cause reflux

Gastroesophageal reflux disease can be caused by foods difficult to digest such as processed foods, sugars, and those with refined carbohydrates.

acid-reflux-1-1100x700

 

Foods that help relieve acid reflux

The following may help relieve acid reflux symptoms:

  • Oatmeal
  • Banana
  • Salad
  • Aloe vera
  • Parsley
  • Celery
  • Couscous
  • Rice
  • Lean turkey and chicken

 

Here’s another chart that shows foods that may help or trigger reflux:

reflux foods

Elevating the bed 45 degrees at night helps reduce reflux symptoms.

Avoiding drinking lots of water before sleep helps as well.

Eating smaller meals and avoiding a large dinner at bedtime will decrease acid reflux.

Heartburn Medication Found to Double Risk of Stomach Cancer

So why take medication at all?

Those suffering from GERD can be prone to esophageal cancer if the stomach acid bombarding the lower esophagus fails to be subdued.  Acid reflux can also cause chronic sore throat and chronic cough.  For these reasons, PPIs will still be recommended for severe reflux cases, but maybe lower doses and combinations with other drugs and lifestyle changes should be started first.

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in food, Health, news

Don’t Mix Supplements and Herbal Remedies if Taking Medication

Another warning has been issued to adults and seniors who mix herbal remedies, over the counter supplements and prescription medications.

A study from the University of Hertfordshire in the UK found 44% of women and 22% of men surveyed mixed their prescription medications with herbal remedies and over the counter supplements.

Individuals may have changes in their metabolism and medication breakdown as they age causing variances in body absorption and efficacy of medications.  Adding supplements or herbal remedies could cause unpredictable reactions.

These effects could include:

  • Less efficacy of prescription medication causing poor blood pressure, sugar, heart rhythm control, for example)
  • Enhanced active compounds of medications taken (possibly causing overdose)
  • Nausea
  • Vomiting
  • Body aches
  • Jaundice
  • Blood thinning causing easy bleeding
  • Renal failure
  • Liver failure
  • Anemia
  • Mania and other personality changes
  • and  more

For example, St. John’s Wort could interfere with the effectiveness of one’s birth control and ginseng could worsen’s ones hypoglycemia if they are taking insulin.

Grapefruit juice could interfere with the metabolism of a statin, a popular medication used to decrease cholesterol. By raising its levels in the blood, one drink could cause a patient to have increased side effects such as muscle cramps and liver issues.

Iron supplements can interfere with one’s absorption of their thyroid medication, and ginko biloba, if taken with a blood pressure medication, could cause the blood pressure to drop even lower.  Moreover it can increase bleeding if taken with an anticoagulant.

And if alcohol is mixed with any prescription medication, deadly side effects (such as respiratory depression when used with opiates) can ensue.

So the moral is, just because a supplement states is “natural”, or a frequently consumed food appears to be safe, its combination with medication could prove deadly.

Although the interactions are numerous, the AAFP created a table of common ones:

 

Herbal and Dietary Supplement–Drug Interactions

HERBAL OR DIETARY SUPPLEMENT DRUG COMMENT RECOMMENDATION*

Patients taking oral anticoagulants

Cranberry (juice)

Warfarin (Coumadin)

Interaction possible based on seven reports of increased INR, although a clinical study showed no interactions47

Suspect an interaction if INR elevated

Fish oil

Warfarin

Interaction possible, with case reports showing an elevated INR, although a clinical study showed no effect of fish oil on anticoagulation status8,9

Suspect an interaction if INR elevated

Garlic

Warfarin

Interaction unlikely based on a clinical study that found garlic is relatively safe and poses no serious hemorrhagic risk for closely monitored patients taking warfarin oral anticoagulation therapy10

Suspect an interaction if bruising or bleeding occurs despite an appropriate INR

One review found no case reports of interactions with garlic and warfarin11

Ginkgo

Warfarin

Interaction possible, though controlled clinical studies show no effect of ginkgo on the kinetics or dynamics of warfarin12,13

Experts recommend caution, although available research does not support this conclusion

Aspirin

Interaction suspected based on four case reports of spontaneous bleeding14,15

Suspect an interaction if spontaneous bleeding occurs

Ginseng

Warfarin

Interaction possible based on conflicting research findings

Avoid combination if possible

American ginseng (Panax quinquefolius)reduces blood concentrations of warfarin16,17

Coadministration of warfarin with Asian ginseng (Panax ginseng) did not affect the pharmacokinetics or pharmacodynamics of warfarin18

St. John’s wort

Warfarin

Interaction suspected based on decreases in INR in case reports and in a study in 12 healthy volunteers18

Evaluate warfarin response when St. John’s wort is initiated or stopped

Vitamin E (> 400 IU daily)

Warfarin

Interaction suspected based on a single patient (with rechallenge), resulting in an increase in INR19

Evaluate warfarin response when vitamin E is used in combination

One clinical trial showed no interaction20

Patients taking cardiovascular medications

Eleuthero (Eleutherococcus senticosus) [corrected]

Digoxin

Possible increase in digoxin levels without clinical signs (case report)21

Monitor digoxin level when eleuthero is initiated or stopped [corrected]

St. John’s wort

Digoxin

Suspected decrease in digoxin levels without clinical signs in a controlled study22

Monitor digoxin level when St. John’s wort is initiated or stopped

Verapamil (Calan)

Interaction suspected based on decreased bioavailability in a study in eight healthy volunteers23

Increase verapamil dose, if necessary, if diminished response occurs

Statins

Interaction suspected based on decreased plasma blood levels in a clinical study24

Monitor serum lipid levels after St. John’s wort is added

Patients taking psychiatric medications

Ginkgo

Atypical antidepressant (trazodone [Desyrel])

Interaction possible based on one case report of coma25

Evaluate for emotional and/or behavioral changes in patient response after ginkgo is initiated or stopped

Ginseng

Monoamine oxidase inhibitors

Interaction possible based on two case reports of manic-like symptoms, headache, and tremulousness17

Avoid combination if possible

St. John’s wort

SSRIs

Interaction suspected based on case reports of drowsiness or serotonin syndrome26

Taper off St. John’s wort when initiating an SSRI

Benzodiazepines

Interaction suspected based on pharmacokinetic studies showing decreased serum levels (25 to 50 percent) without clinical signs2729

Adjust the dose of benzodiazepine as needed

Tricyclic antidepressants

Interaction possible based on decreased amitriptyline plasma levels but no clinical effects in a study of 12 depressed patients27,30

Monitor patient response after St. John’s wort is initiated or stopped


INR = International Normalized Ratio; SSRI = selective serotonin reuptake inhibitor.

*— All recommendations have a strength of recommendation taxonomy (SORT) evidence rating of C (consensus, disease-oriented evidence, usual practice, expert opinion, or case series). For information about the SORT evidence rating system, see https://www.aafp.org/afpsort.xml.

Information from references 4 through 30.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

 

 

 

Posted in diabetes, food, Health, news

Leftover Pasta May Be Better For Diabetics than Freshly Made

Pasta is usually a no-no for those with high blood sugar as it has a high glycemic index. But researchers reveal a trick to allow those with diabetes to enjoy the popular dish:  cooling and then reheating it the next day.

Express.co.uk reports the following:

 ……eating cooled or reheated pasta can help reduce the rise of blood glucose levels, according to an experiment led by the University of Surrey’s Dr Denise Robertson and TV doctor Chris van Tulleken.
This is because when starch is cooked in water and then cooled, it changes shape.
The new structure is resistant to enzymes in the body so can’t be digested, becoming what is known as ‘resistant starch’.
When regular starch becomes resistant starch, most of the sugars it contains aren’t released in the gut, meaning the body will take in fewer calories from the same food.

When study authors tested their theory, they found cooled and reheated pasta did not cause the same spike in blood sugar as freshly made pasta.  There was still a surge in blood sugar, but not as much.

What is resistant starch?

There are four classifications of resistant starch.

resistant starch 1.jpg

Resistant starches get their name by being “resistant” to digestion.  They are carbohydrates that don’t get broken down as easily and act like fiber. The less they are digested, the less their “sugar” can enter the blood stream (diabetes explained below).  Starches that are cooled and then reheated undergo changes in their carbohydrate composition, rendering them less vulnerable to enzymatic breakdown.

Foods with resistant starches are found to be more beneficial when it comes to  insulin sensitivity and gut health.  They include:

  • Legumes
  • Oats
  • Green Bananas
  • Whole grains
  • Cooked and cooled rice and potatoes

 

resistant-starch-1024x986.jpg

 

What is Diabetes?

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes Explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

Type I vs. Type II Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 

dmp-blood-sugar-levels-chart

SOURCE DIABETESMEALPLANS.COM

Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

For more information, visit http://www.diabetes.org/.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada