Bananas as the Perfect Food?

Searching for the perfect food?  The one that provides all your nutrition needs?  One that will save you from having to prepare food?  One that that you can spend your limited food budget on?  Well, if you read this post about bananas, you might think you have found your holy grail: After reading this, you’ll never look at a banana in the same way again.  Does any of this information have any use?   Let's look at each one.

**Some of this I have already covered in previous posts, here, here, and here.

1) (Opening paragraph)--"Bananas contain three natural sugars – sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy."

Well, yes, the banana does contain "natural sugars" and fiber.  All fruits do, some just have more per portion than others. (As opposed to "refined sugars?"  Or "artificial sweeteners?"  Which means you are probably not eating fruit....) I will also point out, for those of you haven't taken (or have forgotten) basic chemistry, you will find that sucrose is actually a disacharide made up of the monosaccharides glucose and fructose, so you could just say "bananas contain carbohydrate" and be less redundant.  I think the "energy" they are referring to the carbohydrate converting to blood glucose within about 15 minutes to two hours after consumption (depending on what you ate with it).  If your blood glucose is low, you will feel better after eating a banana (or any fruit, really), but that rise in blood glucose is only going to last for maybe an hour or two.  Hardly sustainable.
**If you have diabetes and experience a blood glucose level below 70 mg/dL, fruit might work in a pinch but you will have to do less peeling/chewing if you consume 4 oz fruit juice or consume 3-4 glucose tablets.

2) Depression

No one food is going to cure your depression, as I have written about here.  And in a previous post I stated this:
"Bananas do contain serotonin, and some people who have depression have a shortage of this, but the serotonin found in the banana does not cross the blood-brain barrier. If someone has been eating poorly, eating a banana or another carbohydrate rich food might give them a temporary sense of well being, but it won't last. Bananas could be worked in to an otherwise healthy meal plan to help overall depression but they are not a cure unto themselves."

3) PMS

If you read the above links, I mentioned this before.  Hint: The answer is "No."
They also mentioned blood glucose regulation causing you to feel bad--which is true--if you have uncontrolled diabetes or even prediabetes eating to control those conditions can help you feel better.  But one banana contains roughly 30 grams of carbohydrate--about the amount per meal that a person with diabetes could have (if they are trying to stay about 100 grams per day, some people need less).  Not everyone is going to want to use up their carb selection on a banana (or eat just half a banana).  As far as B6 is concerned; a banana only contains about 0.4 mg per banana and the studies on blood glucose regulation used much higher doses.  And the results were poor as well.

4) ANEMIA

Your body absorbs iron the most efficiently from "heme" sources, which usually means animal products.   For those who choose to be vegan or vegetarian, however, and are trying to find a variety of non-heme sources, you want to have foods that contain at least 3.5 mg iron per serving (best) or on the low range of 0.7 mg (serving).  The banana weighs in 0.26 mg/serving so no help there.  If you are low in iron, you might need short term supplementation under a physician's guidance.  (The dose that your physician might use is probably on the lines of 26 bananas per day or ~1.5-2 pounds of liver for the non-vegetarians, which is not really realistic to consume).

5) BLOOD PRESSURE

Already discussed.  But let me repeat: Remember that you can also get potassium from all meats, fish like salmon, avocados, apricots, legumes, leafy greens, etc. I suppose bananas might be a convenient source for some, but not the only one.

6) BRAIN POWER

I actually had trouble finding a reliable source that said that this "study" even took place.  Although if the students were skipping meals and not getting enough fruit and vegetables this may have contributed to better performance.  Again, I suppose the bananas were a convenient source of potassium.

7) CONSTIPATION

Well yes, they do have fiber, but so do other fruits and vegetables.  If you absolutely hate other fruits and vegetables I suppose this would be preferable to taking a fiber supplement.

8) HANGOVERS

It looks like we might need a hangover primer here, but guess what, we already talked about that too (in the videos in the link).
The fruit by itself can give you some well needed carbohydrate if low blood glucose levels are making you miserable, and the potassium in the banana could help with the hydration too.  As far as bananas "calming" the stomach acid, there have been some animal studies that indicate that bananas might speed the healing of stomach ulcers, but there may not be much of a change of pH.  Milk does contain some potassium as well, but as far as the "soothing" of the system, which of the eleven body systems are you referring too? 

9) HEARTBURN

From a previous post: "There was a small study done in India back in 1990 hat used a banana powder to treat GERD, but that is not the same as eating a whole banana. Anecdotally, some people complain of worse GERD symptoms after eating bananas. If you are unable to handle too much fructose, like yours truly, it could be that the resulting intestinal gas puts pressure on the lower esophageal sphincter. There does not seem to be any harm in trying the banana powder for GERD as long as you are working to find out what is causing the problem."

 10)  MORNING SICKNESS

We are not sure exactly what causes morning sickness, it might be the change in hormones or possibly the lower blood sugar levels, we don't know.  But if it is a blood sugar problem, you actually don't want to be snacking on bananas or other high carbohydrate foods.  The hormonal changes in pregnancy can lead to insulin resistance, which means that the cells in the body do not allow the insulin to "upload" glucose into them like the body usually does.  As a result the pancreas needs to produce more insulin to keep the blood glucose regulated.   Sometimes the pancreas can't keep up, and the result is gestational diabetes, which all pregnant women need to get screened for.  How this relates to banana/carb intake is that if you eat too much carbohydrate (remember one banana has 30 grams), your body has to try to produce extra insulin to handle the resulting glucose load, and that overproduction of insulin can cause you to have a blood glucose "crash" later on (if you have gestational diabetes and take insulin, you have to minimize your carb intake to avoid having to take high doses of insulin).  Making sure that you get most of your calories from protein and good fats, while filling in with 30-45 grams of carbohydrate at each meal (depending on what the weight gain limit is) will be more likely to prevent those blood sugar crashes.  Will it help with morning sickness?  Maybe, we don't know.

11) MOSQUITO BITES

Previous post: "Lots of anecdotal information on this one, but no studies that I could find. I wouldn't recommend trying this if you have already scratched and have an open wound though."

12) NERVES

       1)  I think they might be talking about bananas as anti-anxiety as opposed to working on the nervous system, so see above comments on depression.  Surely they couldn't be talking about calming they voluntary or involuntary nervous system--I don't necessarily want my nervous system calmed down because it might involve stopping my heart or my digestive system.  Read this for a brief overview of our wonderfully complex nervous system.
        2) See "morning sickness" for why overloading on carbohydrates does not stabilize a person's blood glucose.

13) ULCERS
    
See above for "heartburn."  Also, regular consumption of bananas might help increase the production of the mucus that normally protects the stomach lining against acid, but the banana itself does no "coating."

14) TEMPERATURE CONTROL

Bananas do not reduce fever, nor do they keep you from having bad "qi" since the latter does not exist.

15) When you compare it to an apple, it has FOUR TIMES the protein, TWICE the carbohydrate, THREE TIMES the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals.
    
1) An apple has zero grams of protein.  Do the math.
2) Let's see, I can only have 30 grams of carbohydrate at this meal so I could eat one apple and something else or I could eat a whole banana.  I like volume and variety, so apple it is!
3) An apple has zero phosphorus.  Do the math.
4) An apple has zero vitamin A.  You know what you have to do.
5) Covered iron above.
6) Really?  How much math do you have to do?

Take home message--Bananas are good source of potassium and fiber.  No magic.

Food cravings?

In just a few months we in the western world will be begin a new year, and with that new year some of us decide that it is a good time to change the way we eat.  Of course some people find themselves quickly derailed by a "craving" for [insert previously eaten food here].  A food craving is defined as an intense desire to consume a specific food, stronger than simple "normal" physical hunger.  Just about anyone who has changed the way the eat, even those who have been successful, can tell you a story about how they have longed for something that is no longer part of "the plan."  Food cravings are just one more obstacle that a lot of people have when it comes to achieving whatever the health goal is, so it's not a surprise (to me anyway) that one of the more popular ideas that pops up periodically is the idea that if you are craving a specific food you must be "deficient" in some type of micro nutrient (aka vitamin or mineral).  I've seen a variety of these "articles" floating around on social media (and spouted by well meaning relatives and friends trying to help you not eat whatever you are craving), but I think I managed to find a summary chart:
Food cravings

I am pretty sure some of you some of you saw immediately that the website had "naturopathy" in the title and decided to dismiss it outright.  For more on the quackery that labels itself naturopathy read this piece at sciencebasedmedicine.org.  For those of you who were still curious and managed to read all of it; unfortunately there is no evidence that cravings are actually a sign of micro nutrient deficiency.  Lets take the every popular "I'm craving chocolate so I must be low in magnesium" statement.  Symptoms of magnesium deficiency often include agitation and anxiety, restless leg syndrome, sleep disorders, irritability, nausea and vomiting, abnormal heart rhythms, low blood pressure, confusion, muscle spasm and weakness, hyperventilation, insomnia, poor nail growth, and even seizures.  That's not to say that if you are feeling irritable eating a magnesium rich food source, or taking a supplement, won't help you feel better, but there is no mechanism in your body to increase your cravings for chocolate.  (And I know those of you struggling with tobacco addiction are wishing fervently that eating nuts would help you stop smoking.....if only it were that easy).

When it comes to foods high in calories (usually via carbohydrates and fat), keep in mind that humans have long been able to survive times of famine throughout history due largely to our ability to store excess calories, consumed during times of plenty, as body fat. So you might say that craving high calorie foods is part of our omnivorous/eat-whatever-we-can-find-to-survive programming.  Since those of us that have regular access to food are usually dependent on cheap, easy to obtain refined carbohydrates and processed fats; when we take that away, even though our mind knows we are improving our diet, our body is still wanting to that easy access to store up calories in case of a famine so we don't feel good.  Think about people who start a very low carbohydrate plan, like Atkin's induction diet; many of them experience fatigue, irritability, nausea, and intense cravings for sugar because the easy source of blood glucose has been removed.  After a few days the body will start using ketones for energy and they will usually start to feel better, but some people still feel horrible after a week or so and resume their former eating habits with a vengeance.  Or think of someone who decides to become vegan without learning about alternate protein sources and they try to survive on pasta; they go from getting adequate protein and fat to very little and they probably don't feel so good.  They either go back to eating cheeseburgers or they just try to fill up on more pasta and take in even more calories.

And then there's the "other parts" of eating, the parts that associate certain foods with good memories, family and friend celebrations, and the fact that certain parts of our brain (hippocampus, insula, and caudate) that control for memory and sensing pleasure are activated during food cravings.  Think about how many people who have tried to change their eating dread holiday celebrations with family and friends because they know that the "comfort foods" abound.

So now that you no longer have the excuse of "I want chocolate so I'm going to claim a magnesium deficiency" to fall back on, what could you do to manage your cravings and still change your eating lifestyle?
1) Plan to eat at least 3 meals per day.  If you are just starting out with a lifestyle change, now is not the time to think about fasting.
2) Make sure that you have protein, fat, and vegetables at each meal, if you are not diabetic, make sure that you include unprocessed carbohydrates like fruit, sweet potatoes, etc.  By making sure that you have the minimum of your protein needs and by allowing yourself to have the healthier fats, you can take the edge off the "starving" feeling.  If you have Type 2 diabetes or prediabetes, or some other insulin resistant related condition, limiting the carbohydrates will keep your body from having to over-produce insulin and inflate your hunger.
3) Clean out your kitchen.  Most of us do not lay awake thinking about the leftover pork loin, but we might lay awake thinking about the cookies.  Keep the temptation unavailable.
4) If you can find a lower calorie/lower carbohydrate option that tastes good, feel free to use a small amount daily.  (Your low carb ice cream only stays low carb if you eat about 1/2-1 cup per day.  You know who you are.)
5) If you are eating a "substitute" that you find that you don't like, stop eating it so you don't eat it and then whatever you are craving. (I'm old enough to remember rather unpalatable foods like Molly-mcbutter, etc.)
6) Get the small bag of candy, cookies, or one piece of pie, instead of the family size/the whole pie. Enjoy each bite.  
7) Some people do better with going cold turkey off certain foods, some people do better with gradual changes.  You know you the best.
8) If you do indulge in a craving, go back to your regular healthy eating habits as soon as possible.  Don't try to starve yourself the next day or you'll wind up back in the same cycle.  Shaming/punishing yourself doesn't usually work.
9) Find ways to stay busy in between meals so you don't eat because you are bored.
10) Start learning to bring your own meals and snacks to work so that you don't wait to long to eat and start working on whatever is left in the break room.
11) When you do enjoy your well planned treats, try to do so with supportive friends or family.  Nothing kills the enjoyment by other people judging you for eating foods of your own choosing.

Take home message--eating an overall healthy diet that contains all the essentials can help manage cravings, but there are no specific foods that will do so.

Holiday Diet Tips?

This time of year is an interesting time to be a dietitian (at least in the northern hemisphere).  If you are not being asked about magical foods to cure what ails you, you are getting asked to write articles about how to avoid weight gain during the time between roughly between October 31 and February 14 known as the "holiday season."  It's an important topic to people who really want to maintain the hard work they've been doing the rest of year but still want to engage in the "usual" family and cultural traditions that are important.   Actually addressing it is problematic, however, because this is not a topic that has a lot of double blind studies to back it up, and there are also some social implications too as I was reminded by when I read this quite amusing (to me) blog post entitled simply Horrible Holiday Diet Tips.  In other words, we don't really have a lot of "proven" advice to give and some of the advice really falls into the "shame your fat friends and relatives" category as opposed to actually being helpful.   Unfortunately, non of this stops people from asking/worrying about getting through the holidays, so I've decided to address a short collection of some common diet tips and see if there is an physical or behavioral science to back it up.  Keep in mind that this advice/discussion is for people genuinely looking for healthy eating tips; some people might just want advice on how to deal with less than supportive family at holidays.  If you are the latter, there is a companion piece to the above blog post over here.

1) Eat a Big Bowl of Fiber Cereal and Drink Lots of Water Before A Party to Avoid Snacking.  Obviously this one comes straight from the blog post above.  I can see where this advice comes from, since fiber is suppossed to slow down the emptying of the stomach, people trying to lose weight have been told to eat fiber cereal/apples/take metamucil  before any meal (not just holiday ones) in the hopes that they will fill up faster (the water is also there to help the fiber "swell" and enhance fullness).  Unfortunately, there haven't been any good studies that show that this is actually the case, and remember those "fiber cereals" are usually anything but low calorie. (Link)  So, she's right in that you might not eat as much at the party because you are spending too much time in the bathroom.  If  you know you are going to be consuming alcoholic beverages later you probably do want to start hydrating before so you are less likely to be hungover later.

2) Save Your Calories For the Party by Eating Light During the Day.  (Thanks again Ragan!)  In this post I talked about the pro/cons of intermittent fasting.  So, for those of you who fall into the category of people whom this might benefit, and are already practicing it, this tip probably sounds like your everyday life.  As a practice to start on the day of the party, however, this is a really bad idea as you probably will be ready to eat everything in sight.  Eating healthy takes a lot of work, don't expect to change your biological programming to eat food all in one day.

3) Make it easier on your guests by offering light and satisfying appetizers, etc.  If you are like my friend Jennifer, who does amazing gluten free baking, and have brought some tasty gluten free treats for you and your celiac disease friends to share, I think that is very courteous.  If you are vegan and have made it clear to your guests that you don't wish to have animal products served in your house, I think you are setting boundaries for yourself that others should respect.  If you are inviting your low carb friends over to show off how many things you can wrap with bacon, great.  But, I don't know of any studies that showed that you as the host could somehow slow anyone's holiday weight gain, as you can't control what they ate before or what they will eat after the party.  Be courteous, but don't police them.

4) Substitute  [insert trendy "good" ingredient] for [insert trendy "bad" ingredient] for a delicious low calorie treat!  Well, maybe.  As someone who eats gluten free and enjoys cooking, using and learning about new substitutes is part of my daily life, not just the holiday season.  But not every substitute makes something lower calorie, lower carbohydrate, etc.  You have to actually look at the label and/or analyze the recipe to see if what you are getting is actually any healthier.  Sounds pretty basic but some people get caught up in the hurry of the holidays and don't check.  But this is another area where people get caught up in the "little" things and forget that the evidence favors people enjoying a drink of regular eggnog in the context of a "most of the time" caloric/carb restriction. 

5) Suggest a walk or other activity after the main holiday meal.  Another well maybe.  Going for a walk can obviously remove you from easy access to food which can save a few calories.  Holidays with family can also be a stressful time for some people, and going outside for a walk or other activities to temporarily remove yourself from a stressful situation can just be a nice act of self care.  I think where I have seen some people get in trouble though is that they really think the walk will burn enough calories to compensate for overeating (you know who you are), and after a heavy meal you probably won't be walking/running/biking that fast.

6) Use a smaller plate.  I sometimes wish there was a link between plate size and all the hormones and GI system receptors that code for satiety, but it looks like people are more likely to eat until full regardless of plate size (Link).  You

Take home message--There is no magic trick to keep you from gaining weight during the holidays.  If you have found a plan/lifestyle change that is working well for you the rest of year (which for most people means eating a certain way 80-90% of the time), you will have to keep up that way of eating during the holidays.  Do make sure that you find ways to stay in touch with those who have been supporting you so far.

Honey as an antibiotic?

We are in to cold and flu season, and with that comes everybody and their mother giving you advice on their favorite cure and/or symptom relief.  I managed to see this one in my feed the other day:

Sounds pretty good doesn't it, particularly if your throat has been hurting so bad you have trouble swallowing.  But is there any evidence for it?

The slipperiness of the gelatin probably will feel good and make it a little easier to swallow, which might actually help you feel better and maybe you can even take in more liquids and other nourishment that your body needs while your sick.  You can also get similar relief from hot tea, etc, but some of need variety after days of drinking the same old broth, etc.

The statement about the honey killing the bacteria that might be causing a sore throat is a distortion of the truth.  There have been some small studies indicating that MEDICAL GRADE honey might help heal wounds like pressure ulcers, etc, but there is still a lot more research that needs to be done (Link).  (And yes, I did emphasize MEDICAL grade as you would not want to put something that likely contains botulism spores on an open wound.)  When it comes to an internal problem, such as a sore throat that is caused by a bacterial infection, like strep throat, there is no evidence that honey will take care of it.  You will likely need a course of anti-biotics to cure the problem

What's the harm in using this remedy if you are feeling crummy?  If you are merely seeking relief of your symptoms, nothing (other than I've seen way too many people with diabetes run their high blood sugar up even higher with remedies like this).  If your symptoms indicate you might have strep throat, however, and you don't get this treated, the infection could potentially spread to other parts of your body and even in to your blood stream, and that could be deadly.

Take home message--Gelatin and honey might provide you with symptom relief (just watch the amount if you have diabetes/pre-diabetes), but don't expect it to "cure" the problem.

Also, for those of you new to the blog, I have also talked about:
Honey and allergies, more than once.
Cold Eze
High doses of Vitamin C

Hint: The answer is usually no.

**Update.  Thanks to JP for reminding me that I should have been clearer about the term antimicrobial.  Antimicrobials are substances that are applied to living tissue/skin to prevent infections, hence the use of medical grade honey in treating pressure ulcers, etc.  Antibiotics are substances that actually need to be transported through the lymphatic system to kill bacteria in the body.  Applying a "coating" of honey does not prevent a strep infection from taking hold, and once you have an infection you will need an antibiotic.

Diabetes Month Tip of the Day

Question
How does one get diagnosed with diabetes?

Answer

First of all, keep in mind that a “normal” fasting blood glucose level is 70-99 mg/dL and if everything is working as it should in the body, your blood glucose levels shouldn’t budge over that even if you’ve eaten something.

If someone has two consecutive fasting blood glucose levels of 126 mg/dL or greater, or a random blood glucose level of 200 or greater, that is enough for us to diagnose diabetes. 

If the fasting level is between 100-125 mg/dL, this level is called “pre-diabetes,” which is pretty serious as you have a 25% chance of progressing to diabetes in 3-5 years.  Even more worrisome is that there is a developing body of evidence that indicates that some people might develop complications like diabetic retinopathy (eye disease) or neuropathy (nerve damage) at this stage.

Other thoughts

1) One of the other tests that might be done is the oral glucose tolerance test (OGTT) which you can read more about here.  Because this test is more time intensive and costs more it has fallen out of favor, particularly at the hospital where I work that serves a population that has to drive far and wide to get their primary care.  The advantage of this test though, is that if you have noticed "normal" fasting levels but you have seen high "post meal" levels, looking at your post-meal response can actually catch a blood glucose problem early and you can start your intervention earlier.

2) Some of the warning signs that you will often see on diabetes awareness posters include the excessive thirst, excessive urination, and excessive hunger that I discussed yesterday.   These symptoms are most common in Type 1 diabetes which tends to have a more rapid onset, but people with Type 2 can develop these symptoms as well.  Unfortunately, a person can actually have blood glucose levels in the "diabetic" range before  these symptoms develop, and the evidence points to intervening early on to prevent complications of diabetes.  The American Diabetes Association recommends that individuals 45 and over get screened (by looking at the fasting blood glucose) initially at age 45 and then every 3 years.  Some people can get screen at a younger age if you have a parent or sibling with the disease, have a "constellation" of problems like high blood pressure/heart disease/high cholesterol levels, and/or are overweight or obese as defined as having a BMI over 25.  (I know, I know.  Here's a link back to my other post about better ways to examine weight.)

3) If your physician/provider notices a problem with the blood glucose levels, I recommend using that as a wake-up call to change your eating habits to prevent future complication.  Sometimes a person in a high risk group might actually be given medication to help combat the high blood glucose levels, but that is between the individual and his/her medical provider.

 

 

It's Diabetes Awareness Month!

I've been working hard on some educational tips for my co-workers to post everyday during the month of November (at least on the working days).  Since that took away from some blogging time, I figured that I should combine both!  Obviously I am starting on this blog about 7 days late, but I will try to make up for it!!  (And I will get to expand beyond the "tip" format that I am e-mailing co-workers).  So here we go.....

Day 1

Question
What is diabetes?

Answer

Diabetes, or diabetes mellitus, is the name given to a group of diseases in which athe main symptom that a person has is high blood glucose (blood sugar).  The blood glucose becomes high either because the body does not make enough of the hormone insulin, or because the body’s cells do not respond properly to insulin, or both in some cases.   There are three types of diabetes:

Type 1:  In this form of diabetes the body does not produce insulin at all and people must take insulin to control the blood sugar and follow a carbohydrate-controlled diet.  People will Type 1 are usually diagnosed before their 40^th year and usually present with the symptoms of weight loss, frequent urination, increased thirst, and increased hunger (Those last three are called polyuria, polydipsia, and polyphagia, for those of you who are interested).  This form of diabetes used to be called “insulin dependent diabetes,” “juvenile diabetes,” “or early-onset diabetes.”  These terms were discontinued because they are too confusing and not accurate, particularly since some people are diagnosed "as adults."  Type 1 diabetes only makes up about 5-10% of the cases of diabetes.

Type 2:   This is the most common form of diabetes (about 90% of cases) in the United States and this also makes up the bulk of SkepticRD's case load.   In this form of diabetes the cells in the body do not react to insulin (insulin resistance) or the body does not produce enough insulin, or some combination of both.    If caught early enough this form of diabetes can be treated with a carbohydrate controlled diet and exercise alone.  For those who are diagnosed “later” or who are unable to follow a carbohydrate controlled plan (for whatever reason), they may need to be treated with medications that help sensitize the body to insulin or help the body make more insulin.   Type 2 diabetes is progressive and many people do wind up having to take insulin to control blood glucose levels.

Gestational: This form of diabetes is used to describe elevated blood glucose levels in pregnancy when the woman’s body becomes resistant to insulin.  Some women are able to control this with a carbohydrate controlled diet alone and others may require insulin during that time.  This usually resolves after giving birth, but some women are more at risk for Type 2 diabetes in the future.

Other thoughts:

1) I have had a lot of people with Type 2 over the years tell me that they didn't think they had the "bad kind" of diabetes, particularly if they had not progressed to the point of taking insulin.  I had to follow up with a very frank discussion about how they are just as much at risk for complications (more about that in another post) as someone with Type 1.  And I had to restrain myself from giving a smart aleck answer about how I don't consider any chronic illnesses to be "good."

2) In future blog posts I will also talk more about what a carbohydrate controlled diet plan actually looks like.  I have to keep you all reading don't I?

3) I have worked with an older adult population for my 16 year career, so I don't have a lot of experience in this area, but do have a skeptic related story.  One of my pregnant co-workers was actually told how to "cheat" on her gestational diabetes screening test by someone at her OB/GYN office.  Basically this person told her to follow a carbohydrate controlled plan for two weeks before her test, then if the results were "fine" she could go ahead and start eating her desserts, etc again.  She was at least able to ask me about this and I was able to gently remind her that if she is eating in such a way to control her blood glucose levels BEFORE the test that she should continue to eat in such a way AFTER the test so that her developing fetus would be as less risk for excessive birth weight, pre-term birth, respiratory distress syndrome, etc.  She just delivered a third healthy child so we could all breathe a sigh of relief for now.

See you tomorrow for the next educational tip!