Seventeen years ago, Neil Vogel was a certified financial officer at a New York hospital when he was diagnosed with type 2 diabetes.
His physician told him that in addition to medication, he needed to change his diet and exercise. “I took a different approach,” said Vogel, 64, who now lives in Parkland. “I didn’t lose weight or exercise and the weight gain continued.”
Vogel tried “just about every fad diet” over the years without success. “I’d lose weight, then gain more. I was completely out of control. I’d eat a half-gallon of ice cream sitting in front of the TV.”
Then, nearly two years ago, Vogel’s concerned wife Jill told her husband that he was in such poor health, “she was afraid I’d pass away sooner rather than later. She said we had good things ahead of us and I needed to do something. Her talk inspired me.”
The next big step: A healthcare consultant referred Vogel to Sonia Angel, a registered dietitian and certified diabetes educator at Memorial Regional Hospital in Broward. “It completely changed my life,” Vogel said. “She took a different approach and it worked.”
When Angel learned of all the diets Vogel had tried and failed, she asked him a question: “So what does this tell you about diets?” His reply: “They don’t work.”
Choosing a healthier path “is not a diet or a weight-loss program. I told him that this is a change in your lifestyle and we’re going to work on it one step at a time.”
Angel started Vogel’s exercise program, for instance, with a 10-minute walk in the pool. That time gradually increased to 90 minutes and then he started riding his bike, a short distance at first. Vogel now bikes 10 to 15 miles a day. “I couldn’t even get on a bike before. Now it’s something I truly enjoy.”
As for diet, he’s learned to make wiser choices, reducing portions, ordering more wisely in restaurants and learning to look at food from a nutritional standpoint. Among his many changes, Vogel now eats high-fiber cereal instead of sugary choices, lots of salads without rich dressings and snacks like nonfat popcorn, plain Greek yogurt and fresh fruit and vegetables.
Vogel’s exercise regimen and “common sense” approach to eating has paid off. He’s lost 185 pounds since February 2015, dropping from a size 66 waist to size 40.
“I’m a different person than I was a year and a half ago,” he said.
More importantly, he’s a different diabetes patient. His blood sugar levels have dropped from more than 200 to about the mid-70s. And he takes a much lower dosage of his medication.
“You can control diabetes (type 2) through exercise and weight loss,” he said.
About 1.4 million people in the United States are diagnosed with diabetes annually, according to the American Diabetes Association. In 2012, 29.1 million Americans, or 9.3 percent of the population, had diabetes. Of that number, 1.25 million American children and adults had type 1 diabetes and the rest had type 2.
With type 1, primarily diagnosed in children and young adults, the body stops producing insulin, the hormone the body needs to get glucose from the bloodstream into the body’s cells. With type 2 diabetes, the body doesn’t use insulin properly. About 95 percent of diabetes cases are type 2, which can be prevented or improved with healthier eating habits and regular exercise. Obesity and type 2 diabetes are linked.
“Not every obese person has diabetes but it does set them up for a higher risk, absolutely,” said Amy Kimberlain, a registered dietitian and certified diabetes educator at the Diabetes Research Institute at the University of Miami Health System. “Sedentarism is contributing to increased risk of more chronic diseases, not just diabetes.”
More than a quarter of the nearly 30 million people who have diabetes don’t know it.
“They may not present symptoms in the beginning,” Angel said. Signs of diabetes can include extreme thirst, frequent urination, extreme fatigue, dry mouth, increased hunger, blurred vision, high blood sugar, and in some cases, unintentional weight loss.
Too often, people may ignore the symptoms or attribute them to other causes, experts said.
“People need to understand that diabetes can be a devastating disease,” said Larry Hausner, past CEO of the American Diabetes Association. “It requires lifestyle changes to hep control it.”
Before people develop type 2 diabetes, they usually have prediabetes, which means their blood glucose levels are higher than normal, but not yet high enough to be called diabetes. In 2012, 86 million Americans age 20 and older had prediabetes, an increase from 79 million in 2010.
The Centers for Disease Control and Prevention reports that without weight loss and moderate physical activity, 15 to 30 percent of people with prediabetes will develop type 2 diabetes within five years.
“I tell patients I have two very effective medicines,” said Dr. Michael Swartzon, a sports medicine physician with Miami Orthopedics & Sports Medicine Institute, part of Baptist Health South Florida. “One is exercise and one is diet.
“It’s hard to get patients to start a diet and exercise program,” he said. “Everyone wants to live a longer, healthier life. Diet and exercise are key, especially for diabetics.”
The American College of Sports Medicine and the American Diabetes Association recommend adults get at least 150 minutes of moderate-intensity exercise a week. You can divide that in different ways. Try 30 to 60 minutes of moderate-intensity exercises five days a week or 20 to 60 minutes of vigorous-intensity exercise three days a week. Even exercising in shorter sessions is helpful.
“We’re spending too much time on different types of screens, from our screens at work to our TV screens at home to video games,” said Hausner, interim CEO for the Society for Women’s Health Research. “We’re just not moving around.”
Some need to start exercising in stages. “You have to meet people where they are,” Kimberlain said. Just taking a brisk walk for 10 minutes at breakfast, lunch and dinner helps. “People can get exercise by doing what they love — swimming, biking, dancing.”
Ideally, aim for a combination of aerobic and resistance activities, Swartzon said. “This doesn’t mean you have to go to the gym and lift heavy weights.”
Aside from weight lifting, resistance exercise options include push-ups, core-strengthening plank exercises, squats, knee bends, exercise bands or the fitness stations in your neighborhood parks.
A range of everyday activities can get muscles working, Swartzon said. “Washing the car, doing housework, cleaning the pool. Gardening can be a form of exercise.”
He points to studies comparing sedentary and active groups. “Those who exercised had a significant reduction in average blood sugar, cholesterol and blood pressure,” Swartzon said. “These are very important numbers for diabetics.”
Studies show that “people at high risk for diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their weight, if they are overweight — that’s 10 to 14 pounds for a 200-pound person,” the National Diabetes Education Program reported.
“The biggest thing is portion control,” said Natalia Torres-Negron, a registered dietitian at Cleveland Clinic Florida in Weston. “And it’s important to avoid certain foods, including those that are high in sugar, high in fat and high in sodium.”
It’s advice that’s helpful to any healthier lifestyle.
“There’s nothing magical about it,” said Vogel, who credits his family and Angel’s support for helping him make changes. “If you’re not motivated, it won’t work. But if I can do this, anyone can.”
How to live a more healthy life
▪ Sign up for the USDA’s My Plate’s tips and nutrition information at choosemyplate.gov/. The recommendation: fill half your plate with fruits and veggies (spinach, broccoli, kale, tomatoes are good places to start). After that, one-quarter of your plate is for proteins, another quarter for whole grains.
▪ Portion control is key; check out the American Diabetes Association for serving size guidelines.
▪ Eat leaner sources of protein including turkey, chicken and fish as well as beans, peas, nuts and seeds. If you eat red meat, eat smaller portions and make it lean.
▪ Eat whole grains, which include quinoa, oats, amaranth and barley. Substitute brown rice for white rice. Replace sugary cereals with high-fiber cereals like oatmeal or ones made with whole grains.
▪ Eat fiber-rich foods to avoid between-meal grazing. For a snack, consider a hard-boiled egg with a handful of almonds, carrots and celery with a half-cup of hummus or a tablespoon of peanut butter and an apple.
▪ Eat fruits high in fiber, including berries, pears, apples (with the skin on). Raspberries are a star, with 8 grams of fiber per cup.
▪ Avoid soda, fruit juices, punch and sweetened iced tea. Check labels for the sugar used in juices. Eat the fruit instead.
▪ Watch the sugar. “Be careful of the syrups added to coffee,” Torres-Negron said. Look at condiment ingredients. And know what’s in your smoothie. “You can make a very healthy smoothie or an unhealthy smoothie,” she said. Don’t think of honey as your go-to sweetener. “Honey is still going to affect your blood sugar levels and affect calories.”
▪ Replace lunch meats, hot dogs and other processed foods with grilled chicken, turkey or fish.
▪ Avoid high-fat dairy foods. Drink skim milk or 1 percent milk, not whole milk. Eat plain Greek yogurt; add your own fruit.
▪ Skip fried foods loaded with saturated fats and packaged food like chips, candy, cookies and cakes.
▪ Develop a plan for the holiday season. “Some people will skip meals all day then load up on food,” Torres-Negron said. “Follow a normal eating pattern.”
▪ Move. Exercise is a crucial part of a healthy lifestyle. If the prospect is overwhelming, take small steps. You may not want to join a gym but you can dance in your living room.