Janine Freeman, RD, LD, CDE
Education Program Specialist,
Department of Food and Nutrition

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September is National Cholesterol Education Month. Do you know what your cholesterol is?

If you have diabetes, it's very important for you to keep your cholesterol under good control. Diabetes makes you much more likely to develop heart disease, and if you also have high cholesterol levels, your risk of heart disease is much greater.

What is cholesterol? Cholesterol in the blood is like a fat. Some of it is made in your liver and some of it comes from the food you eat. When you have too much in your blood, it sticks to the insides of your blood vessels, causing the openings to become narrower, and makes it more difficult for blood to get to your heart and brain. High cholesterol levels can then cause heart attacks and strokes.

Although we think of all cholesterol as being "bad", there are different types. LDL cholesterol is referred to as the "bad" one that clogs your arteries. HDL helps prevent heart disease, so is often referred to as the "good" one. Make sure you have your doctor check your total cholesterol, your LDL and your HDL cholesterol. These are the numbers you should try to achieve:

• total cholesterol -- less than 200
• LDL cholesterol -- less than 100 mg/dl
• HDL cholesterol -- greater than 45 for men and greater than 55 for women.

How do you keep your cholesterol under control? What you eat and how much you exercise have a major effect on your cholesterol. Some people whose bodies make too much cholesterol also have to take medication to control cholesterol.

You can begin by making some lifestyle changes.

1. Choose more fruits, vegetables, and whole grain breads, cereals and pastas.
2. Choose baked, skinless chicken and fish, and low-fat dairy products.
3. Eat less fat, especially saturated fat, like butter, meat fat, regular cheese, dairy foods made with whole milk, and fatty meats. You can tell a fat is saturated when it is solid at room temperature like butter, bacon grease, and shortening.
4. Food that are high in trans fats can also clog your arteries. This is another reason to eat fewer foods like shortening, stick margarine, fried foods, and baked products that you buy in the store. Margarine that is soft or liquid at room temperature is better for you than if it is in stick form. The amount of trans fats in a food may soon be listed on the nutrition label.
5. Increase the amount of physical activity you get each day to help improve your cholesterol. You don't have to go to the gym or take an aerobics class to get the benefit of exercise. Walking, swimming and bicycling are great ways to benefit your health. Activities that you do around the house like gardening, mowing the lawn, raking leaves and vacuuming the floor also count. Try to get some moderate exercise for at least 30 minutes most days of the week.

A new combination diabetes drug, Glucovance, was approved recently by the Food and Drug Administration (FDA) for the treatment of type 2 diabetes. This is the first diabetes medication that combines two types of drugs into a single pill.

Glucovance contains the drugs Glucophage (metformin) and an older drug, glyburide. The two drugs have different types of action in the treatment of diabetes. Glucophage improves a person's blood glucose by preventing the body from making as much glucose and by helping a person use his/her own insulin more effectively, both common problems for people with type 2 diabetes. Glyburide, on the other hand, helps the pancreas make more insulin.

Results of studies of Glucovance show better blood glucose control with milder side effects than with either Glucophage or glyburide alone. Patients in one study showed an average drop in blood glucose of 41 mg/dl at the end of 20 weeks.

You may now only have to take one pill instead of two to help your diabetes in two ways -- help your body make more insulin and make your body more sensitive to insulin. This may only be the beginning of many more combination drugs in the future.

"What's for dinner? Reservations!" used to be a joke, but now it's truly reality in America. Instead of "what should we fix for dinner," it's "where shall we go for dinner?"

We're all concerned that Georgians and all Americans are gaining more weight. Is it because we're eating out too much? Think about the foods you choose when you eat out and compare them to your home-cooked meals. Are you eating more when you eat out?

PORTION SIZES
Servings are usually larger in restaurants than at home. How often do we complain that we didn't get enough to eat in a restaurant? Owners and managers at restaurants try to fill us up because they think we're more likely to return and spend our money at their restaurant. Because we don't want to waste food, we usually clean up our plate instead of stopping when we've had enough. Another option, of course, is to take some of it home. But, do you? Ask your server to take half of it and put it in a doggy bag at the beginning of the meal. That way you won't be as tempted to finish it. Another suggestion is to share the main dish with your companion. Each of you can order a salad and/or side dish to go with it.

HIGH IN FAT

Restaurant foods are usually higher in fat. Maybe you steam your vegetables or cook them in chicken broth at home, but you often get them fried or served with a lot of butter in restaurants. You may grill or bake chicken, fish and lean meat most of the time at home. But, the fried chicken or pork ribs on the menu sound so delicious that you feel like treating yourself (again.) And, of course, they just happen to come with high-fat cole slaw and french fries, foods you rarely eat at home.

Although you and your family may lead very busy lives with little time to prepare elaborate meals, it takes little time to prepare simple and healthy meals at home. Here are some tips.

1. Don't wait until you get home from a long, exhausting day to decide what you're going to eat. Plan ahead so you know you have the ingredients you need.
2. Get some help from the rest of the family if you know you'll be home late. Children often appreciate being a part of the decision-making and will be more likely to eat healthier food if they've helped prepare the food.
3. Make a grocery list to limit your trips to the grocery store.
4. Choose simple-to-prepare meals that take little time to cook like grilled chicken breasts and baked fish. Microwave some potatoes and broccoli. Add some fresh fruit and you'll have a meal in less than 30 minutes.

Splenda, the new no-calorie sweetener made from sugar, will be available in stores in September. The sweetener, which contains sucralose as the sweetening agent, was approved in 1998 for use in the United States and has been used in beverages, juices, gum and other prepared products. Splenda is now available for purchase as a table-top sweetener in packets or in granular form for cooking and baking. The packets are yellow in color to distinguish them from the usual blue and pink packets of their competitors. The sweetener has virtually no calories and does not affect blood glucose levels.

As with any no-calorie sweetener, some baked products work better than others when sugar is replaced. Recipes and tips for use in cooking and baking are available at their Web site at www.splenda.com.

Check with your local grocery store or warehouse-type discount stores to purchase the new sweetener.