Watch the archived webcast video above, and then test your knowledge below by taking our short quiz.

Learn more about upcoming Speaker Series events »

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Along with these dietary changes, many also wonder if they should choose lower fat milk, avoid fried foods or opt for margarine over butter. While choosing foods containing lower levels of fats won’t directly improve blood sugar levels, this can help protect and improve heart health. That’s important because people living with diabetes may be at risk of developing heart disease up to 15 years earlier compared to people who don’t have this condition. Here are some of the reasons why:

Gender
In Canada, women with diabetes are 4 times more likely to develop heart disease due to its connection with hormonal levels during menopause, as diabetes cancels out the protective effect that estrogen provided.

Insulin resistance
Insulin resistance plays a role in the development of diabetes and prediabetes. Insulin is the hormone in our bodies that regulates energy or glucose, and resistance happens when the cells in your muscles, fat and liver don’t respond properly. Over time, your blood sugar levels go up because your body isn’t able to use glucose from your body for energy. Insulin resistance plays a role in the development of plaque in the arteries. If plaque builds up too much, it can lead to blocking the blood vessel, significantly increasing the risk of heart attack or stroke.

Unhealthy cholesterol levels
Diabetes can increase the risk of “bad” cholesterol in the body, and lower the “good” cholesterol, which in turn can increase the risk of stroke and heart disease.

High blood pressure
Many people with type 2 diabetes also have high blood pressure, also known as hypertension. There are likely many factors contributing to both conditions including obesity, a diet rich in fat and salt as well as inactivity.

Inactivity
Physical activity is important for overall general health, and may be especially important if you have diabetes. It can help maintain a healthy weight, keep the heart strong and reduce insulin resistance.

Increased body weight
Insulin therapy can lead to weight gain, as insulin promotes fat storage in the body. In turn, being overweight or obese means your heart has to work harder to do its job, increasing the risk of heart disease and other cardiac complications.

Ways to protect your heart

When it comes to diabetes there are many ways to protect your heart, such as having regular check ups with your doctor or endocrinologist to monitor your blood pressure, cholesterol and blood sugar A1C to get these levels into health ranges. The target ranges for blood pressure and cholesterol are much lower for people with diabetes, and similar to targets for someone who has already has had a heart attack or stroke. It’s also important to not smoke, and to take any medications as directed.

Coming back to diet, it plays a critical role. Worldwide, diets low in fruits and vegetable are major contributors to the risk of developing diabetes and heart disease, and nutrition therapy is an integral part of managing both conditions together. Generally, avoid processed foods as they are normally high in salt, sugar and saturated fat. Opt for fresh fruits, vegetables, legumes, beans, lentils, nuts, whole grains and lean proteins, while limiting alcohol intake. Be sure to reach out to your diabetes care team for more information and direction.

View the full Speaker Series event here:

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While these certainly may be great ideas, you might want to re-think how you word it, says Dr. Jeremy Rezmovitz, family doctor on Sunnybrook’s Academic Family Health Team.

“It’s not enough to say ‘exercise’,” he says. “We need to reframe this and ask ‘what are my health goals and how can I achieve them?’”

Dr. Rezmovitz says in his practice, he works with his patients to set ‘training goals’.

Training means approaching lifestyle changes in a structured, measurable and goal-oriented way. It makes Dr. Rezmovitz, as he puts it, “a health coach”.

For example, if a patient is found to have high blood pressure, Dr. Rezmovitz doesn’t simply pull out his prescription pad and call it a day.

“We talk about it,” he says. “What are the benefits to lowering your blood pressure? Do you want lower blood pressure? Do you want to do that with or without medication? Would you change your diet in order to achieve that goal?”

Sustained high blood pressure can put patients at risk of heart attack and stroke. Stress, genetics, diet and low physical activity levels can increase your chance of having high blood pressure.

“So, in the case of high blood pressure, I can’t change your genetics, but we can outline some goals that could help you lower it, if that is your goal,” he said. “If you want to make healthy eating choices, don’t buy potato chips the next time you do your grocery shopping. If you want to eat healthier lunches, plan ahead, pack your lunch and skip the drive-through. Align your actions with your goal. ”

Dr. Rezmovitz recommends talking to your primary care doctor or nurse about your goals, be they around your blood pressure, physical activity level or reducing your risk of illness.

“It’s a real shift in the relationship with your care team,” he says. “Rather than just taking about what ails you today, let’s talk about your overall health and your overall values. Is the way you are living your life matching those values?”

So maybe today you are a few pounds heavier than you’d like to be, he says. But instead of making your goal “lose weight” and then losing heart when you step on a scale, reflect on why you want to lose that weight.

“Maybe you want to lose weight so you can live longer, or you can avoid diabetes or you can reduce your risk of stroke,” Dr. Rezmovitz says. “So then instead of making the goal a negative action — like “lose weight” or “stop eating badly” — reframe it into a positive one: what will you do to make a change?”

And that’s where the training approach comes in, he says.

“Let’s reframe it together: I want to live a long life, free of illness. How can I do that?”

(A version of this post appears as a monthly health column in The Leaside Streeter)

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Before you panic (or call your grown children and start nagging, Mom), wait – the yearly check-up for your family doctor to bang your knees with her little hammer or listen to your breathing has kind of gone out the window.

According to Dr. Sharon Domb, Division Head of Sunnybrook’s Academic Family Health Team, research suggests that annual physical visits aren’t exactly necessary or effective at catching disease early or preventing chronic health issues.

But you aren’t off the hook.

“You should still visit your family doctor at least once a year – but the focus for family physicians has shifted toward prevention,” Dr. Domb says.

Here are some tips from Dr. Domb to help you communicate with your doctor on your next annual preventative visit.

Ask ‘Is my screening up-to-date?’

Your doctor will likely ask you this and have access to your records. But you can still start the discussion. For example, sexually active women over age 21 should be having a Pap test every three years. There are other guidelines for cancer screenings. Check Cancer Care Ontario  for more information.

Share your family history.

Your doctor likely took a family history when you had your first appointment (which may have been years ago!) and so things change. Changes in your family members’ health could have an impact on your health. “So, you are 40 years old. You normally wouldn’t have any screening for colon cancer yet,” Dr. Domb says. “But, let’s say your father or sibling has just been diagnosed with colon cancer – those screening recommendations change and so it’s important for your doctor to have all the information.”

Learn more about immunizations.

Your doctor will offer you the standard immunizations but there are also new or optional immunizations (not covered by OHIP) that may be recommended by physicians. For example, the shingles vaccine has been approved and recommended for adults over age 50. (And may soon be funded according to the provincial budget).

Ask your doctor about the latest vaccines that may be recommended for your age or your children.

‘Is there something I can do to my lifestyle to reduce my risk of chronic disease?’

Maybe it’s your weight. Could be your diet. Maybe you have difficulty finding the time or energy to exercise. Talk to your doctor about how to prevent illness. “Do you smoke? Be honest with your doctor. We can give you support to help you quit,” Dr. Domb says.

Ask about Advance Care Planning.

Do your loved ones know your values and wishes in the event of a devastating illness or accident leaves you unable to speak for yourself? Is now a good time to start having those discussions? Your family doctor can help you get advance care planning discussions started. (Visit advancecareplanning.ca for more information)

Remember: Secrets, secrets are no fun. All they do is hurt someone.

When it comes to your health, secrets can hurt you!

Firstly, at your annual visit or during any visit, be open and honest about other remedies you are taking. “It’s generally believed anything ‘natural’ or ‘homeopathic’ is unharmful and therefore, patients often don’t mention them to me,” Dr. Domb says. The truth is, these other remedies can have interactions with prescribed medications. So, share the list with your doctor.

Secondly, tell your doctor about stress and weight changes. “Patients come to me saying, ‘I need to be off work for six months, I can’t handle the stress,’ and when I ask how long it’s been going on they say a year,” Dr. Domb says. “If only they’d have come to me sooner.” Your family doctor can support you before it gets to the point that you are at the end of your rope. A similar situation often occurs with weight changes – if you gain or lose a significant amount of weight, talk to your doctor.

Sounds like communication is key when it comes to your annual check-in with your doctor. (Don’t worry Mom, I’ll give my doctor a call!)

If you don’t have a family doctor, visit Health Care Connect.

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Seeing your family doctor?

At your annual check-up, ask or tell your doctor about:

• Screening and immunizations
• Family history
• Lifestyle
• Advance Care Plan

Secrets can be bad for your health. Talk to your doctor about your

• remedies and supplements
• Weight gain or loss
• Stress level

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A version of this post appears in the Town Crier newspaper in Toronto, Ontario.

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1. Quit smoking.

If you smoke, make a plan to quit. (And if you don’t smoke, don’t start. Within months, quitting smoking reduces your risk of a heart attack, improves breathing and helps circulation. After a year of quitting, your risk of heart disease and smoking-related heart attack is cut in half. Start by making a quit plan. Need help? Check out sunnybrook.ca/quitsmoking or talk to your health-care provider.

2. Cut down on sugar.

The World Health Organization (WHO) suggests we try to keep our sugar intake to less than 6 teaspoons a day (not including naturally occurring sugars, like in fruits). Eating too much sugar has been linked to cardiovascular disease and other health issues. Do you put two sugars in your tea? Try cutting back to one. (Even better, none!) Keep an eye out for hidden sugars. Cereals, yogurts, salad dressings and sauces can often have a wild amount of added sugar. Choose these items with less sugar (or use less dressing when tossing your greens!)

3. Add an extra veggie to each lunch.

Cut up some celery sticks to eat with your sandwich, or add broccoli to your pizza. Sneaking an extra vegetable in at lunchtime can help you reach Canada’s Food Guide recommended servings of vegetables/fruits (7-8 for adult women, 8-10 for men). Eating the recommended amount of vegetables can help reduce your risk of many chronic diseases.

4. Try a meatless Monday (or at least one meatless meal per week)

Have one vegetarian meal each week that includes legumes like beans, chickpeas or lentils. Legumes are packed with protein and fibre, and are lower in saturated fats than most meats. Eating more legumes can help manage diabetes and improve cholesterol levels. Need inspiration? Try this three-bean chili. 

5. Add three 10-minute chunks of activity to each day.

We know you’ve heard this one: adding daily activity to your lifestyle has many health benefits. But remember, daily activity doesn’t mean you have to spend hours at the gym. Try to add three 10-minute chunks of medium activity. Park farther away from the doors and briskly walk, get off the bus a stop early, have a walking meeting or take the stairs). Check out Canada’s Physical Activity Guidelines for more ideas.

 6. Take electronics out of the bedroom.

To improve your sleep quality, make your bedroom a no-phone zone. Leave phones, TVs, tablets or other things with bright screens out in the living room. Actually, studies show that avoiding these devices one hour before bedtime can improve your sleep quality, leaving you better able to make healthy choices the next day.

The post 6 nice things you can do for your heart this year appeared first on Your Health Matters.

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It’s National Non-Smoking Week

Some startling stats about smoking

• 600,000 people died of second-hand smoking globally in 2011
• 75% of those who died of second-hand smoking were women and children
• 17%: Canada’s smoking rate has dropped to 17%, but that’s still 5 million Canadians who smoke
• 6 million: Tobacco kills nearly 6 million people per year globally
• $4.4B: tobacco addiction is the leading causing of preventative disease, disability and death, costing Canada’s health care system

Find more information at

www.sunnybrook.ca

www.smokershelpline.ca

www.quitnow.ca

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The first step sounds obvious, but you have to want the change, say Sunnybrook experts. The next is making sure the change is realistic and sustainable. For example, rather than vaguely promising to eat better, start adding one fruit or vegetable to every meal. It’s a small shift but one you can see and do pretty easily. It’s also something you can track and build on over time.

Like anything lasting, build you diet plan on a solid foundation. Get your information from reputable sources, like certified websites, your doctor or a registered dietitian. While people have varying reasons for changing their diets, experts say you’ll have more success by focusing on your overall goals rather than your weight. Maybe that extra serving of veggies will help you feel fuller, meaning you may skip dessert and reap the rewards later. Call it a healthy domino effect.

Being accountable to yourself and others also boosts success. So tell a loved one or friend about your plan and check in with them regularly on your progress. Also, write everything down. It’s amazing how small things can add up – like those extra few bites — when you do you end-of-day tally.

It may also help to look to outward for some inspiration. The quotes and tips below are ones I’ve read from others along the way. While I can’t remember all the sources, the message from each point resonates with me and helps keep me on track. Hopefully you’ll find some truth in a few to help feed your inner voice.

• You can’t outrun your fork.

• Suck up the water now so you won’t have to suck it in later.

• Live by the 80/20 rule: eat well 80% of the time and give yourself 20% to cheat.

• Are you really hungry? In trying to distinguish between real hunger and a craving, ask yourself if you would be happy to eat something healthy. If you are craving chips but not that bag of veggies, you have your answer.

• If you are craving something, choose a high quality treat. Make it worth the calories.

• Hide your fruit and veggies. Load them into omelets, sandwiches, pasta and soups.

• Never go grocery shopping hungry. Or to a dinner party for that matter!

• You are what you eat, so don’t be fast, cheap, easy or fake.

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As millions embrace the release of The Hunger Games on the big screen, health professional students all across the GTA are gearing up for a battle of their own – entering into the job market.

In preparation for our final test of aptitude and intellect, students spend upwards of six-to-eight years training in demanding post-secondary and clinical institutions.

We write, we present, and we collaborate until we’re sure that we cannot possibly do it again.

And then we do.

This same process is then repeated in the hospital setting where we must prove to our peers and superiors that we are capable and competent. Not a small task when we are also trying to convince ourselves.

During our training, we all develop unique strengths and clinical skills. As the end nears, however, we also begin to realize the incredible number of other students just like us – each with their own set of skills. It is after this realization (and as graduation looms), that conversations about extra learning or networking opportunities become more guarded, and job search strategies become strictly confidential.

At a time of economic uncertainty and instability in healthcare funding, health professional students feel especially vulnerable. As an article in the Globe and Mail last week highlighted, “competition for jobs when the unemployment rate is high has given employers the luxury of being more selective in new hiring’s.” Just reading those words has the ability to increase student anxiety.

Despite this, I myself will enter the job search arena next week. I am keeping my fingers crossed that when I am selected, it is for a job opportunity and not for The Hunger Games. Although at this moment they both seem to be a fight for survival. I know the competition is tough, but I am confident I will be successful in my hunt. My only concern is how hungry I will get before I succeed.

Looking back on my training, I am thankful for my many mentors and teachers both at Sunnybrook and the University of Toronto. They have provided me with the tools I need to begin my career as a Social Worker, and are cheering me on as I take this next step. They have also reminded me that, “we are all learners”, and that although my formal instruction is ending, I have a lifetime of learning ahead of me.

Stacey Creak

Social Work Intern

Sunnybrook Odette Cancer Centre

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