The “supersizing” of American’s diets and waistlines is evidenced by larger drink sizes in coffee shops (what happened to “short” sizes?), fast food chain supersize meals, and extra meat and noodle options at local noodle restaurants. And our obsession with bigger meals goes hand-in-hand with the rise in type 2 diabetes.

It wasn’t long ago that type 2 diabetes used to be called “adult onset” diabetes because you developed it later in life. But it’s occurring more often in our overweight children. One in three Americans are now obese and this growth doesn’t exclude Asian Pacific Americans (APAs), according to 2011 studies by the National Institute of Diabetes and Digestive and Kidney Diseases. For APAs, it’s not simply environmental—there’s a genetic component. Type 2 diabetes is actually higher in APAs compared to Caucasians.

There are differences among APA ethnicities as well. In Hawai‘i, for example, Native Hawaiians are five times as likely as whites living in Hawai‘i to die from diabetes, according to the U.S. Deptartment of Health and Human Services’ Office of Minority Health. Filipinos in Hawai‘i have more than three times the death rate as whites living there.

While people may know that type 2 diabetes is bad—so bad that it can damage your heart, nerves, kidneys, eyes, and shorten your life span—many aren’t doing much to improve diabetes. Why is this? It’s the same reason why more Americans continue to gain weight: Establishing a good diet, exercise, and weight loss routine isn’t easy. We know what we should do to get healthy, but we just don’t do it.

The problem with making healthy lifestyle changes and sticking to them is that we live in a “microwave” society. We are used to instant, immediate results. So I want to enlighten you with some habit-forming routines to help with type 2 diabetes.

1. Eat healthier more often. Ditch that daily grande mocha and blueberry muffin fix. If you’re going to do it, try limiting your coffee and muffin intake to only three times a week (or less!). Just make a decision to eat healthy at least 80 percent of the time, or just have a cheat day. Moderation is key.

2. Start with ten minutes of exercise every day. For the people who say there is no time for exercise, you need to make time. During your lunch break, walk five minutes in one direction, then walk five minutes back. Eventually ten-minute walks will turn into twenty-minute walks.

3. Eat smaller, frequent portions through the day to regulate blood sugar, and, more importantly, to control cravings. Restaurant portions have gone through the roof. Instead, think of half being the new whole. Split a meal with a friend, or take half home for later. It’ll be cheaper too!

4. Eat off a smaller plate. An equal serving of noodles that “looks” miniscule on a 12-inch dinner plate can actually be a satisfying meal when eaten on a smaller plate, according to a 2012 study, “Plate Size and Color Suggestibility: The Delboeuf Illusion’s Bias on Serving and Eating Behavior,” by K. Van Ittersum and B. Wansink in the Journal of Consumer Research.

5. Be aware of emotional eating. We live in a society of foodies, where it’s now fashionable to eat out and even take selfies with our food. Eating out with friends is fine, but if you find you crave foods in certain situations like when you’re stressed, anxious or depressed, you may be an emotional eater. Unfortunately, the food we do overeat is never broccoli. It’s usually starchy carbs like breads, rice, and sugar—all of which raise our levels of dopamine, the “feel-good” brain chemical. Look for healthier ways to deal with stress instead of turning to comfort foods.

6. Keep track of what you eat. Food journaling can double the pounds lost compared to those who don’t track eating habits, according to the Kaiser Permanente Center for Research. I recommend not to track using a spreadsheet or the newest app. Use old school pad and paper. Anytime food or liquid goes in your mouth, write it down. If it’s a hassle to jot this down every time, you’ll adjust to something healthier rather than writing it down!

Most realize that eating less and exercising more will help you lose weight, and in turn improve type 2 diabetes. The hard part is figuring out how to do that consistently. Remember that slow and steady builds a great habit. Start slow with the suggestions I provided, and remember it’s okay to cheat every now and then. Making changes is never easy. If it were, then type 2 diabetes wouldn’t be at an all time high. Talk to your health care provider for more information.

Dr. Michael Corsilles, ND, PA-C, currently practices as a naturopathic physician and a physician assistant in Bellevue.

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