If you subscribe to my newsletters, you may have noticed last week's theme was diabetes and pregnancy.  This subject can create fears for pregnancy, birth and beyond.  Pregnancy with diabetes used to greatly increase the odds of an unhappy outcome.

However, the causes are much better understood today and pregnancies are more closely followed with standard protocols in place.  As a result, with tight control of blood sugar levels and good medical care, a woman with diabetes can have about the same chance for a successful pregnancy as a woman without diabetes.

In an exclusive interview for New Idea Magazine, Australian Aboriginal sprinter Cathy Freeman revealed her pregnancy triggered the development of Type 2 diabetes.  She is in her second trimester of pregnancy.

Freeman won gold at Sydney's 2000 Olympic Games.  She is an elite athlete who would not seem to be at high risk for Type 2 diabetes.  However, Type 2 diabetes runs in her family and she is also a member of a very high-risk group.  Aboriginal Australians have a high rate of Type 2 diabetes--the fourth highest high-risk group in the world.  Their risk of developing gestational diabetes is two to three times higher than the general population of Australia.

As I mentioned, tight blood sugar levels and good medical care make a difference.  Education and knowledge help make it a whole lot easier:

Gestational Diabetes Toolbox

Preexisting Diabetes and Pregnancy Toolbox

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By Stacey Hugues, About.com Contributing Writer

Walmart, already nationally known for providing affordable food and household choices, has recently unveiled a new initiative to offer customers cheap healthy foods.

Their new program contains five key elements:

1. Reformulate thousands of everyday packaged food items by 2015, reduce sodium by 25%, added sugars by 10%, and remove all remaining industrially-produced trans fats. This is huge for chronic disease prevention and management since added sodium, sugars, and trans fats in our food system are closely linked to heart disease and diabetes.
2. Make healthier food choices more affordable. Walmart is initiating a variety of sourcing, pricing, transportation, and logistics initiatives that will drive unnecessary costs out of the supply chain. This is great news because even prior to this initiative the price break was noticeable at Walmart. I often buy bananas at Walmart because they sell them cheaper than my grocery store or even my bulk warehouse store, and I can't tell a difference in quality. However I can tell the difference in quality for some produce. For example, I have to go to a higher-priced store to get a good-quality apple. Produce that has a longer shelf life -- like potatoes, sweet potatoes, and winter squash -- are usually decent quality at Walmart. I've also bought good-quality cantaloupes, avocados and salad greens at Walmart. So I'm excited to see what this initiative does for the quality of the Walmart produce supply. I plan to keep checking in on it.
3. Develop strong criteria for a simple front-of-package seal in order to help consumers identify healthier food options, such as whole-grain cereal, whole-wheat pasta or unsweetened canned fruit at a glance. Time is precious, so helping us to identify healthier foods without a great deal of time spent reading labels is a great initiative. Sometimes healthy package labeling can be misleading. For example, you can find "whole wheat" bread with just 2 grams of fiber or with 6 grams of fiber. It will be interesting to see the criteria Walmart comes up with for labeling foods as "healthy."
4. Provide solutions to address food "deserts" by building stores in under-served communities. This is very exciting news, since I often have clients who have the desire to eat healthier foods but are limited by the variety of foods available to them.
5. Increase charitable support for nutrition programs that help educate consumers about healthier food solutions and choices. As a nutrition educator who is always preaching the benefits of healthy food choices, I'm very excited about this plan for funding.

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I absorbed the news of Jack LaLanne's death with great sadness.  To say I was a big fan is a great understatement.  I have watched his shows, read his books, had his videos on my YouTube playlist and even proudly owned his juicer.

Members of his family reported he died Sunday due to respiratory failure from pneumonia.  He died peacefully in his home surrounded by friends and family.  While he did not make it to his goal of 100, he still leaves behind a very impressive legacy.

He was an early proponent of fitness, raw whole foods, healthy living and positive attitude.  Standing at only 5'6", he was larger than life mentally and physically.  He preached of the detrimental effects of sugar and bleached flour.  He enlightened us to the power of healthy foods and exercise via his long-running daytime television show that ran from 1951 to 1985 and during his many public appearances.

Active, outspoken and still making headlines at 96, he was a living testament to the benefits of healthy living.  He encouraged people to become proactive to try to stave off diseases such as Type 2 diabetes.  His advice, tips, menus and recipes were always diabetes-friendly and helpful for control.  I referred to his advice often.

In honor of his passing I have published a listing of some of his well-known quotes or "LaLanneisms" that are helpful for diabetes and links to information to make them a reality.

Jack LaLanne Quotes for Diabetes

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If you know many people with diabetes, chances are you know a few who are suffering from depression. Perhaps you have struggled with it yourself. About 20-25% of people with diabetes have symptoms of depression, twice the amount as people without diabetes.

A recent study in the Archives of General Psychiatry found that diabetes and depression are a "double whammy" for women and increase risk of death. There was a higher risk of death from cardiovascular disease if depression occurred in a patient who had diabetes over 10 years or used insulin therapy.

The study was based on data from 78,000 women over the age of 54 from the Nurses' Health Study.

The results emphasize why psychosocial support may need to be considered as a standard part of diabetes treatment and may be just as important as diet, exercise and medication.

Increased Risk of Any Death:

Diabetes Only: 35%
Depression Only: 44%
Both Conditions: Twice the risk as those who have neither condition

Increased Risk of Death From Cardiovascular Disease:

Diabetes only: 67%
Depression: 37%
Both Conditions: 2.7 times the risk as those who have neither condition

It was found symptoms of depression increased as treatment regimens became more complex. The most simple treatment was no medication. The most complex was insulin treatment. Researchers felt insulin treatment made patients feel like they were more "doomed" or at the end-stage of the disease, although this is often a misconception.

Researchers recommended both conditions be addressed at the same time in regard to prevention and management. Depression could contribute to poor blood sugar control, poor management, increased risk for complications and feelings of isolation from their social network.

Study Recommendations for People with Diabetes:

• Watch for symptoms of depression
• Get psychosocial support to reduce diabetes management stress
• Monitor blood sugar levels more closely if you have depression

Do you have depression?  Read how to cope with depression.

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