Ask PHN: Reducing Your Risk of Diabetes in Prison

By Lisa Horwitz and Seth Lamming


Dear Prison Health News,

How do I avoid diabetes when the meals usually consist of white bread, white rice, cake, cornbread, fruit served in syrup, and white noodles? I would appreciate any

information you can provide. Thank you.

—Colin Broughton, South Carolina


Thanks for this great question! Type 2 diabetes, also known as adult onset diabetes (high blood sugar), is a common long-term health problem that affects 1 out of every 10 Americans. It can cause many physical complications, and of course we would all like to prevent getting it if at all possible (If you have diabetes, PHN has written a “Diabetes Self-education Guidebook” that we will send you on request).

The cause of diabetes is not really known—so guaranteed prevention is not possible for any of us. It is thought that a combination of environment, genetics, and health choices like diet and exercise cause some people to develop diabetes. Risk factors for diabetes are: smoking, having other family members who have diabetes, being overweight (especially if the extra fat is mostly in the belly), getting little or no exercise, high blood pressure, high cholesterol, diets high in sugars and saturated fats, being of Black, Hispanic, Native American, or Asian/Pacific Island ethnicity, being female, and being over 40 years old. Being low income increases risk, both because of increased stress and lack of access to fresh whole food. But anyone can get diabetes, even if they have none of these risk factors.

Preventing diabetes is about doing what you can to make your body and mind as healthy as possible. Ways to take care of your body include getting enough sleep (more than 7 hours every night), eating a balanced diet, drinking plenty of water, managing health problems like high blood pressure, quitting smoking, and moving your body regularly. Washing your hands regularly and making sure you are up to date on all your vaccines is important to prevent getting sick.

Doing things to lower stress and improve mental health are also important for preventing diabetes. Over time, stress hormones in the body can contribute to high blood sugars. Proven ways to reduce stress are aerobic exercise and slow, deep breathing. Even ten minutes a day of slow, focused breathing has been shown to reduce blood pressure and improve sleep. Box breathing is one technique: Breathe in, counting to four slowly. Feel the air enter your lungs. Hold your breath for 4 seconds. Try to avoid inhaling or exhaling for 4 seconds. Slowly exhale

through your mouth for 4 seconds. Hold again for 4 seconds. 12 Carbohydrates, or carbs, are in most things we eat. When you eat carbs, they get broken down into glucose (a type of sugar) for energy. Carbs are made out of sugars, but they are not all bad. A little more than half of the food you eat should be carbs. Where you get your carbs from is important though. Carbs are in fruit, vegetables, grains, and other things like white bread, cake, and soda. Eating foods that will not cause your blood sugar to be high is harder in prison, where you don’t have much choice over what you eat. It is helpful to learn which kinds of foods are less likely to cause blood sugars to spike, so you can make the best decisions possible. Foods with a lot of fiber and low-fat proteins do not cause blood sugars to spike. Avoiding foods that are highly processed and with lots of added sugar (like factory-made cakes) is a good rule of thumb. In some facilities, medical can order special low-carb diets for people with diabetes.

Foods that raise blood sugarFoods to try instead
White bread, potatoes, pasta, white riceWhole-wheat bread/pasta/tortillas, brown rice, a variety of green vege- tables
SugarSugar-free sugar substitutes like Equal or Sweet’N Low
Flavored oatmeal packetsPlain oatmeal with sugar substitute
Sugary breakfast cerealsPlain cereals with a lot of fiber like Cheerios or Raisin Bran
Chips, candy, snacksPeanut butter and crackers, dried fruit, whole fruits
Soda, juiceWater, tea without sugar, sugar-free or diet drinks
Red meatsLean proteins like chicken, turkey, fish, eggs, beans, or nuts

Regular exercise is helpful for lowering blood sugar, reducing stress, and improving overall health. In general, adults should try to get 150 minutes of aerobic activity per week and strength-training exercises twice per week. Aerobic exercise is anything that gets your heart rate up, like walking fast, jogging, or doing jumping jacks. Exercises like push-ups and squats that target muscles in specific parts of your body are “strengthening” exercises. There are lots of creative ways to exercise, like dancing or yoga. Doing chores like mopping that require endurance can also give you an excuse to get active. Even just getting up and moving around every couple of hours is good for your body if you have limited mobility.

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