10 Dietitians Share Diabetes Prevention Tips for Truck Drivers

So your doctor told you that you have prediabetes (also known as impaired glucose tolerance). Now what?

First the bad news: diabetes is the number one cause of kidney failure, and the number one cause of adult onset blindness in the western world. Also, having to use insulin would disqualify you from driving a commercial truck.

Now, for the good news. You’re not alone. According to the International Diabetes Federation, 280 million people have impaired glucose tolerance (prediabetes). And having prediabetes doesn’t immediately mean you will get diabetes. Diabetes is preventable by lifestyle changes.

Type 2 diabetes can be prevented by lifestyle changes.

In fact, even a relatively small change in weight can prevent diabetes.

So in an effort to help out any long haul drivers recently diagnosed with prediabetes, I reached out to a number of Licensed Dietitians to get their take on this question:

“What’s the ONE suggestion you’d give to someone who already has impaired glucose tolerance and wants to prevent diabetes, but spends most of their time on the road, with nothing but truck stop food available to them?”

I am very grateful for the useful, actionable suggestions I got from these 10 healthcare professionals.

Lara Field Registered Dietitian.jpeg
ONE suggestion to someone with impaired glucose tolerance…

THINK WHAT YOU DRINK!
- Rather than choosing sugar-rich drinks such as soda, juice, lemonade, choose WATER instead! The best thing you can do for your body to prevent diabetes is give it a chance to get hungry every few hours, instead of giving it a constant dose of sugar through beverages. Not only is the limiting the quantity and choosing the right type of carbohydrates (whole grains) important to diabetes prevention, but also timing meals appropriately is vital to prevent insulin insensitivity. Want more? Many people with impaired glucose tolerance can reverse this by simply losing weight. One 24 oz serving of soda typically has about 300 calories. Thus, by removing this on a daily basis, you can lose about 2.5 pounds PER MONTH!
— Lara Field, MS, RD, LDN
Judy Kolish.jpg
I would have them stock their trucks with more shelf stable foods that do not require refrigeration such as dried fruits and nuts, whole grain crackers peanut butter or another nut butter, whole hand fruits, lower sodium turkey jerky without nitrates, energy bars. If a small refeigerator is available then yogurts and lower sugar granola, cut up fruits, lowfat cheese.
— Judy Kolish, RD LDN CDE
Eric Paul Meredith
My advice for truck drivers is to prepare food in advance and set an eating schedule. They should get food from a grocery store versus a fast food chain. Also, truck drivers should invest in a mini-fridge adaptable for cars, which allows them to bring food for the road.

Examples of prepared foods include:

-Healthy beverages (natural ingredient smoothies, 100% fruit and vegetable juices, sparkling water, etc.)
-Whole fruit
-Sandwiches and salads
-Healthy snacks (trail mix, granola bars, popcorn)

In addition to being prepared, truckers should set an eating schedule to avoid excessive snacking.

Hope this helps,
— Eric Paul Meredith, MEd, MS, RDN, CHES, CPT
Lou Ann Chvatal.jpg
Arnas, the ONE suggestion I have for a truck driver with impaired GT is this: make at least one of your daily meals a bag lunch that you’ve packed at home. Here’s the lunch recipe:
one bag of fresh veggies; ¼ cup unsalted nuts; one hard-boiled egg; one piece of fruit; one bottle of water.
— Lou Ann Chvatal , MS, RD, LDN
Kelly Reeser RD LDN CDE.jpg
If I had one piece of advice it would be to avoid all sugary drinks: soda, juice, sweetened teas, energy drinks, lemonade, etc.. High blood sugar can make you thirsty and reaching for sweetened drinks makes it worse. Stick to water and try to keep a regular eating schedule, avoiding going longer than 3-4 hours without food. If you don’t have time to stop for a meal, choose protein snacks like unsalted nuts, sunflower seeds, cheese sticks or beef jerky (keeping an eye on the salt content) or pack a cooler at home and fill it with sugar-free drinks, precut veggies, fresh fruit, and sandwiches.
— Kelly Reeser, RD, LDN, CDE
Rosanne Ainscough Certified Diabetes Educator.jpg
Most truckers feel they can’t change the way they eat because they are at the mercy of what food is available at truck stops. While this is true to a certain extent, there are ways to get some healthier food options. Most Super Walmart stores have room for truckers to pull in a park. These stores offer fresh fruits and vegetables, many already cleaned and cut up. The one group of foods that you are least likely to find at truck stops is fresh produce. Fresh fruits and vegetables are lower in calories and higher in fiber and nutrients. Get a cooler and always carry some fresh produce with you. Including more fresh fruits and vegetables in your meals or snacks is one strategy to help reduce your risk of developing diabetes.
— Rosanne Ainscough, RDN CDE
Jamie Vespa Registered Dietitian.jpeg
My biggest piece of advice would be to avoid sugary beverages, especially soda and energy drinks. Id recommend for them to always keep water on hand to stay hydrated and if they’re wanting something with flavor, add a calorie-free flavor enhancer such as Crystal Light or MiO.
— Jamie Vespa RD, LDN
Laura Brieser-Smith.jpg
Pay attention to high carbohydrate foods. This includes foods such as bread, rice, pasta, cereals, tortillas, crackers, etc. One should eat smaller portions of these foods and try to choose less processed, higher fiber options whenever possible. One should also limit the amount of high sugar beverages and foods consumed.
Trying to get more exercise throughout the day (even if it is just short bouts of walking) is very important, too.
— Laura Brieser-Smith, MPH, RD, EP-C
Sylvia Klinger Licensed Dietitian Nutritionist.jpg
Here are my top tree tips for a truck driver (love helping them as I have a number of cousins who drive trucks and have help them frequently) with impaired glucose tolerance who spends most of the day driving:

1. Pack your meals so you have enough protein, veggies, and your allowed dairy, grains and fruits for the day. Some trucks come equipped with a refrigerator and a small pantry so pack them up with cut up veggies (red peppers are my fav), hard boiled eggs, low fat cheese rounds, wedges or sticks and plenty of low calories beverages, etc.
2. Carry some stretch bands, jumping ropes, or squeeze balls to get some movement at rest stops.
3. Get the rest you need so your body recovers and can go the distance.
One more: check your blood sugars during the day so you know how much you need to eat.
— Sylvia Klinger, MS, RD, LDN, CPT
Hannah Roosevelt Certified Nutrition Support Clinician.jpg
Get it early! Do everything you can to prevent diabetes because if you thought preventing diabetes was hard, managing the disease is even more difficult.
MOVEMENT is one of the best things you can do. I know, I know. Difficult to do if driving all the time. Try to fit steps and movement in when you can. Can you do some jumping jacks or a jog around the truck with each time you stop? Park as far away from the building/rest stop restaurant etc to get in some extra steps.

Physical activity is the special sauce when it comes to managing your blood sugars. With movement your muscles can use the sugar in your blood WITHOUT needing insulin. Diabetes occurs when you don’t make enough or can’t use your insulin so you can’t use the sugar in your blood. So those extra steps can really go the mile in terms of preventing diabetes.
— Hannah G Roosevelt MS, RD, LDN, CNSC

Themes

There's some themes that emerge from the suggestions of these ten dietitians.

  • Limit your consumption of sugary beverages
    • If you're not sure if a drink has sugar, just look on the back at the "nutrition facts", and it will tell you how much sugar is in it.
    • Water, Water, Water
  • Stock up with healthy snacks and foods beforehand
    • Vegetables are a great snack high in fiber, vitamins, and minerals
    • Most fruits are high in vitamins and minerals, BUT also high in sugar
  • Do your best to avoid processed foods
  • Get some movement into your day
    • Walking is a great physical activity, no gym membership required.

5 Little-Known Health Benefits of Walking

What do you do when you want to experience the benefits of physical activity, and make it a part of your life for the long term, but it seems that most methods out there are either not backed by scientific evidence, or require too much time and effort?

Give walking a try!

Think about it. Walking is what kept your pre-agricultural ancestors in shape for thousands of years. They didn’t have CrossFit; they didn’t have leg press machines; they didn’t have 7-minute abs videos.

What they did have, is the need to find food. They would hunt and gather, oftentimes traveling large distances daily.

So why is walking such a well-kept secret if it’s so effective?

Because it’s really hard to make money off of it. It requires no equipment besides a pair of shoes. It requires no DVD to show you HOW to walk (most of us learned around our first birthday). It requires no private space to do it in (so it’s hard for gyms to make money off it). And a company can’t trademark, or patent, walking (though I’m sure many have tried). Basically, the only way a company could monetize walking is through a pedometer, but you can just download a free app to track that. I generally suggest the free version of RunKeeper. It just tracks your walk through GPS, and logs it so you can see your progress.

If you’re still not convinced that walking is a legitimate physical activity, here’s 5 physical and mental health benefits of walking.

Walking burns calories

A man weighing 300 pounds will burn roughly 160 calories after walking for 20 minutes at an average walking pace (3 mph). The number of calories you burn will vary based on your weight, your pace, and how fit you are. While 160 calories may not seem like a lot, if you walk just 20 minutes per day, 5 days a week, for 1 year, that adds up to 41,600 calories – which equates to 12 pounds of fat loss. Increasing your pace, or the duration of your walk increases the calories burned.

Walking decreases your risk of stroke and heart attack

In a Harvard study that tracked the physical activity of 72,488 nurses with follow-ups over eight years, walking at least 3 hours a week was linked to a 35% lower risk of heart attack and a 34% lower risk of stroke. The amazing thing is that the decrease in heart attack risk was the same for 3 hours of walking per week as it was for 1.5 hours of intense exercise per week. So, don’t be so quick to discount walking as “not effective enough”.

Walking keeps your bones strong and healthy

Walking is a low-impact weight-bearing exercise that can help to build and maintain bone density, according to the National Osteoporosis Foundation. In fact, a Harvard study of 61,200 nurses found that walking just 4 hours a week (with no other exercise) was linked to a 41% decrease in the risk of hip fractures. Why is walking so great for your bones? Just like weight lifting forces your muscle cells to adapt by getting stronger, walking places a demand on your bones, forcing them to adapt by becoming denser.

Walking improves your mood

In an Iowa State University experiment, students were asked to either sit, stand, or walk (on a treadmill) while watching a 10-minute video tour of an art gallery. Afterwards they were asked to rate their mood. Those who walked while watching the video had a positive effect on their mood, unlike sitting and standing.

In another study, this time from the University of Texas, 40 patients suffering major depressive disorder were divided into two groups. While one group rested quietly for 30 minutes, the other walked on a treadmill for 30 minutes. Both groups reported a reduction in “anger”, “fatigue”, “depression” and “tension” on a questionnaire. However only the group that walked on the treadmill reported feeling good, with improvements in “vigor” and “well-being”. Of course, walking is no cure for depression and it doesn’t treat the underlying causes, but it can provide short-term relief. So, the next time you’re feeling a little stressed or sad, going for a walk might be just the thing you need.

Walking helps you stay mentally sharp

The hippocampus, an area of the brain associated with learning and memory, shrinks in late adulthood, which leads to impaired memory and, sometimes, dementia. But there’s good news! A study of 120 older adults (average age of 66) found that aerobic exercise, in the form of walking, increased hippocampal volume.

In the study, the participants were split into two groups. The aerobic exercise group started by walking 10 minutes, 3 days a week, and increased the daily walk length by 5 minutes each week, until they got to 40 minutes per session in week 7. After week 7, the aerobic exercise group continued to walk 40 minutes, 3 days a week. The other group was the “stretching and toning” group, who, as you may guess, exercised by doing balance exercises, one yoga sequence, and muscle-toning exercises using resistance bands and dumbbells.

After one year, the adults in the aerobic exercise group (who walked 3 times a week) saw an increase in hippocampal brain volume of 2%, while the stretching and toning group had a 1.4% decrease in hippocampal brain volume. And, as you may have guessed, increases in the hippocampal brain volume of the exercise group were directly related to improved memory performance.

I especially love that study because the participants started by walking just 10 minutes per day. That’s really the best way to create a lifestyle change; by taking small steps, and building upon little successes!

Takeaways

It’s often said that if all the benefits of exercise could be made into a pill, it would be the #1 best-selling pill in the world. I can see it now:

Walking - side effects include improved mood, stronger bones, fat loss, enhanced memory, and decreased risk of death.

So this new year, instead of trying a new fad diet, or the hot new weight loss DVD, maybe start a walking routine. Your mind and your body will thank you.

How to create health and exercise goals you'll actually stick to

Keep reading only if you’re ready to TAKE ACTION

I understand if you’re intimidated by the challenge that lies ahead of you, but know this: there’s never a perfect time to take action, so you have to start somewhere, and you have to work with what you’ve got.

Maybe you want to start exercising because you’d like to lose some weight so you can move around easier. Maybe a recent physical showed that you’re prediabetic. Maybe you’ll lose your CDL is a chronic health condition gets worse. Maybe you want more energy, and less pain.

Whatever your reason is, I repeat, only keep reading if you’re ready to break out the pen and paper, and start writing out your goals, even if right now they seem out of reach.

The B.S. from the fitness industry stops here

There’s no magic pill, no foolproof diet, and no one-size-fits-all infomercial-promoted exercise DVD.

It all comes down to one word: Consistency

That’s right, the number one predictor of a successful diet and exercise program is consistency.

Admittedly, it’s not a very sexy word, not like “7 minute abs”. Consistency means incorporating healthy behaviors into your life, for the long-term. It also implies continuous effort. It’s not a quick-fix solution, which, these days, is a turn-off for most people.

“Alright man, I’ve read this far, get to the point”

The point is there are three aspects to success in any exercise or diet goal.

You have to have a purpose, you have to have a plan, and you have to put that plan into action.

A purpose has two parts: The why and the what.

Why do you want to start exercising (or why should you continue?)

This is by far the most important aspect of your purpose so write down all the reasons for why you have decided to start exercising. You will have to dig deep to find the REAL reasons. Go beneath the surface. Here’s an example:

  • -          Surface reason: so that I have more energy
  • -          REAL reason: so that I can play with my kids without running out of breath and so I can be there to see them grow up and graduate college.

Whenever possible, tie your reason to a positive emotion or feeling like love, confidence, pride, happiness, feeling energetic and strong, having peace of mind, etc.

The deeper the reasons, the easier it will be to maintain and regain motivation after setbacks and obstacles (and yes, there will be setbacks). Take your time with writing out your reasons, because you’ll be referring back to them continuously. And it’s not enough to just think of a few reasons and move to the next step. Write them down. There’s a lot of psychology behind writing down your goals, but basically, it makes them real the second you write them down.

At this point you should be PUMPED to create that goal

First, a note about human nature and goal creation: Having an ambiguous goal like “I want to lose some weight” will only get you half-assed results, if that. But we create goals like those because we are afraid of failure. Actually, I wouldn’t even call anything that starts with the words “I want…”, a goal.

Your goal is going to start with the words “I intend”, because it’s a promise to yourself that signifies personal initiative and determination. The rest of your goal statement that follows will have to be specific (meaning clear and unambiguous) and to create a specific goal it has to be:

Measurable

  • How will you know you have achieved your goal?
  • How will you measure progress?
  • Examples: “I intend to drop X pounds…”, “I intend to decrease my LDL cholesterol to…”, “I intend to bring my blood pressure down to…”

Achievable

  • Is this goal realistic? What are you basing it on?
  • It better not be some guy on TV who lost 30 pounds in 30 days
  • People who successfully lose weight AND KEEP IT OFF, generally shoot for 1-2 pounds a week
  • A goal should be big enough to motivate you but not so large that it overwhelms you
  • I would suggest shooting for 1-1.5 pounds per week.

Time-bound

  • By when do you intend to achieve this goal?
  • This creates urgency
  • This sets up a real PASS or FAIL criteria

Here’s an example of a clear and unambiguous goal:

“I intend to drop 20 pounds, down to a weight of 215 pounds, by October 31st (90 days from now)”

It’s measurable: you will be able to measure your progress towards the goal each week and you will know when you have achieved it (the scale will show 215 pounds). It’s achievable in a healthy way: To achieve it you will have to lose just over one and a half pounds each week. It’s time-bound: You have 90 days, and ONLY 90 days, so better start taking action ASAP.

Now it’s your turn: take the time to write out your goal before you move on to the next step. I cannot stress this enough. Actually get a pen and write it down. You will be referring to this goal daily.

Note: Don’t forget to set up a baseline. So if you want to lose weight, weigh yourself. If you want to decrease your cholesterol or blood pressure, go get those levels checked by a doctor.

You’ve got a goal, now comes the plan

Your purpose is the what and the why. Your plan is the how.

Here I’m going to introduce you to a tool called the Body Weight Planner (for weight loss goals), created by the National Institute of Diabetes and Digestive and Kidney Diseases. This tool allows you to enter your goal, and the time period in which you intend to achieve it, along with the physical activity you plan to implement, and it will tell you how many calories you should be consuming daily to get to your goal weight, as well as to maintain your goal weight once you have achieved it.

The above paragraph might be a little overwhelming, so I’ll show you an example of how the tool works.

Step 1: Go to the Body Weight Planner link and click “Launch Body Weight Planner”. Type in your information and next to “Physical Activity Level” click “Estimate Your Level”. A pop-up box will open up and you will be able to pick your physical activity level at work as well as your physical activity level during your free time. If you are an OTR driver, I would choose “Light” for physical activity level at work. I use the example of a 50 year old, 235 pound, 5’ 10” man who drives a truck and goes biking once a week with his kids. I’ll name him Bill.

Step 2: Type in your goal weight, and how many days you’re giving yourself to reach the goal: The example below is the same 235-pound man (Bill) who intends to drop 20 pounds by October 31st (90 days from now), to get to his goal weight of 215 pounds.

Step 3: In this step you get to decide by how much you intend to change your physical activity. Click the blue “Calculate” button and add an activity you intend to partake in. Admittedly, you’re limited to a few physical activities in this calculator, but remember that it’s small, consistent changes that lead to sustained weight loss and subsequent weight maintenance. So in the example below, Bill decides that he will add walking at a medium pace for 15 minutes a day, which represents a 10% change in his activity level.

Step 4: The tool will output how many calories you can consume to maintain your current weight, achieve your goal weight, and maintain your goal weight once you have achieved it. Keep in mind that most people underestimate how many calories they consume daily. For Bill to drop 20 pounds in 90 days, he has to decrease his calorie consumption to 2210 calories per day, while adding 15 minutes of moderate walking.

So now you have the large picture “HOW”. You know exactly by how much you will have to decrease your daily caloric intake by, and which small increases in physical activity you can incorporate. But, as they say, the devil is in the details, and the details for how to decrease your caloric intake (or increase your caloric expenditure) must be custom to YOU. Some options include:

Portion control: This is basically being very mindful of how much food you put on your plate (or order) and consume. This strategy employs a variety of tactics, including being conscious of serving sizes for prepackaged foods, ordering smaller meal sizes at fast food restaurants, eating only one helping, using smaller dishes and Tupperware, and being very aware of the distinction between “not hungry” and “full”, oftentimes leaving food on your plate to be thrown away if you are no longer hungry. You can watch a video on portion control here.

Supplementation: I’m not a big fan of dietary supplements for weight loss supplements, especially because a large number of them are basically snake oil. Don’t trust reviews from online retailers. Many of those reviews are fake, bought by the companies that sell the products to convince people that the products work. If you DO want to try some sort of weight loss supplement, I would suggest going through the scientific studies - preferably double-blind, placebo controlled studies – instead of asking friends, consulting online sites that take a cut off the top of each product sold, or putting your trust in online retailer reviews. The point is, there are supplements that work, but they’re few and far in between, and if you haven’t developed the necessary healthy habits, you may regain the weight as soon as you lose it.

Calorie Counting: This option means you will have to keep a food log of everything you eat and drink (if it has calories). There are apps that make this a little easier, although they are not always the most accurate. The goal here is not to count calories for the rest of your life, because that’s very tedious, but to start to identify which foods have how many calories, which ones keep you the fullest, and give you the most energy, and HOW MUCH of which foods you can eat daily to achieve your goals.

Commit to an exercise program: Increasing your physical activity levels little by little is a great idea, and can lead to the confidence to start a more intense exercise program. Remember that as you lose weight, most of it will be fat, but a part of it will be muscle, which will slow down your metabolism a little. Flip that in reverse gear by adding resistance exercise to maintain, or even build muscle. Unlike fat, muscle is metabolically active tissue, meaning it burns calories throughout the day.

Monitoring micronutrients: Micronutrients are what food is made up of – carbohydrates, proteins, and fats. Monitoring and adjusting your intake of micronutrients usually means severely restricting sugar and decreasing foods high in saturated fat. This would then leave room to increase foods high in lean protein, unsaturated fat, fiber, and complex carbs, all of which are lower calorie options but lead to greater feelings of fullness, so you eat less.

Those are just some of the options, but each one could take 30 pages or more to fully explain. Keep in mind that your plan does not have to be perfect, nor is it possible for you to account for every difficulty that is bound to cross your path.

With that being said, please reach out (my email is the “contact” section) if you feel you need some help with coming up with a solid weight loss plan and I can point you to some resources, or we can even hop on the phone for a free consultation and start creating a custom program for you. One last point about making a plan: Be like Henry Ford - focus on the can-do part of every problem and you may find that the no-can-do part disappears by the time you get to it.

Time for action

By now you should have a powerful purpose, and an acceptable plan for achieving your purpose. Now comes the part without which the purpose and the plan are useless: ACTION.

DO NOT PUT OFF GETTING STARTED

Tomorrow becomes never. You can make all the excuses in the world: “Arnas wrote that I need to write down my goal in ink and on a piece of paper, but all I have is a pencil and a napkin”, “Tomorrow I won’t have any access to healthy food so I should just start counting calories the day after tomorrow”, “I’m at a truck stop and I really would rather go for my walk in a nice wooded area”, “My 4g is spotty so I can’t see the nutrition facts of this restaurant I’m going to”, “This buffet is all-you-can-eat, and I want to take full advantage of that”, “It’s too early”, “It’s too late”, “My shorts don’t match the rest of my outfit”.

Start where you stand. I understand if you’re parked on the side of a road in the desert somewhere and it’s 2am and you’ve been awake for 20 hours straight. Then schedule a time tomorrow to start putting your plan into action. The earlier the better, because our willpower decreases as the day progresses.

Also there’s one more thing that will really supercharge your mind for achieving your goal. Repeat your goal and the plan by which you intend to accomplish it every night before going to bed and every morning when you wake up.

Key takeaways for creating and sticking to your goals:

It’s all comes down to consistency. To ensure that you stick to, and achieve, your goal, you need a powerful purpose: worthwhile reasons and a specific goal. You need a plan which doesn’t have to be perfect, but has to provide daily direction. And you need to take daily action, so that these new behaviors become habits.

Remember that the timing is never perfect… if you wait for the “right” time to start exercising, I assure you, it will never come. Life gets in the way and there will always be obstacles. But I’ll tell you this, if you start today, and make physical activity and healthy food choices a part of your life, no matter how small, you’ll look back in 90 days and you’ll be impressed with your results.