Diabetes

Cat videos, Coke and other habits you should advise your patients against

The rising popularity of streaming services means that people have instant access to a host of cat videos, movies, TV shows and music with just the touch of your fingertip. And while people are watching less TV, sedentary time has still gone up because of an increase in computer and mobile phone use. Meanwhile, kids who don't drink water are taking in more calories from sugar-sweetened beverages, according to two recent JAMA Network journal studies.

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Here are four habits physicians should address with their patients.

Sitting for extended periods

Prolonged sitting for extended periods—whether it is watching your favorite cat or dog video, or binge-watching Netflix—may be a factor in many of your patients’ lifestyles. A study published in JAMA found that the prevalence of sitting watching TV or videos for two hours a day or more was high among all age groups—children (62%), teenagers (59%), adults between 20 and 64 years old (59%) and seniors (84%)—between 2015 and 2016.

Computer use outside of work or school for one hour or more also increased in all ages from 2001 to 2016. Leisure-time computer use increased from 43% to 56% in children and from 53% to 57% for adolescents. Adults also saw a rise in computer use from 29% to 50%, but the greatest increase was seen in seniors—from 15% to 53%.

People with obesity had a 59% higher chance of spending at least two hours per day watching TV or videos, while those with a high school education had 24% higher odds. Adults with more than a high school education were more likely to use a computer outside of school or work, but less likely to watch TV.

Physicians should encourage their patients to remain active—whether that is hitting up the local gym or going for a walk. Physical activity fosters normal growth and development. It can also make people feel, function, and sleep better, while reducing the risk of many chronic diseases. Adults should do at least 150 minutes a week of moderate-intensity aerobic activity, or 75 minutes a week of vigorous-intensity activity, according to the "2018 Physical Activity Guidelines for Americans."

Drinking sugar-sweetened beverages

When children drink sugar-sweetened beverages (SSBs) it adds empty calories to their diets. It may also increase the risk of weight gain, obesity and diabetes. In a JAMA Pediatrics study, data from 8,400 children and young adults found that the number of total kilocalories and percentage of total energy intake from SSBs varied by water intake status in all age and racial groups.

About 80% of children reported drinking plain water each day. However, among participants between 2 and 19 years old, those who didn’t drink any water intake took in about 93 kilocalories more from SSBs, after adjusting for sociodemographic variables. Children in the U.S. should drink water every day and cut their intake of sugar-sweetened beverages.

Consuming glucose-spiking foods

When patients are choosing what to eat, physicians can help them understand how their body processes and breaks down foods. For example, most people know that eating sugar-filled candies can cause blood glucose levels to rise, but foods don’t have to taste sweet to spike blood-glucose levels.  

Another example is, when comparing a doughnut and a bagel, patients might think the doughnut would cause a higher increase in blood-glucose levels. However, some bagels can cause blood glucose to soar even higher than doughnuts. Other foods that cause glucose levels to rise are white rice and potatoes. Dietary fiber, especially the soluble type, can help regulate blood glucose levels. Patients can look to oats, beans, apples, citrus fruits and nuts as good sources of dietary soluble fiber.

Following diet fads

There is an overflow of fad diets, which can make it hard for patients to sort the science from the hype. Emphasize to patients with prediabetes or at risk for hypertension the underlying principles of healthy eating. For example, consuming the recommended daily servings of fresh fruits and vegetables is one of the key components of a balanced and healthy diet.

The AMA Ed Hub™—your center for personalized learning from sources you trust—offers CME on a broad range of topics, including “Nutrition Science for Health and Longevity: What Every Physician Needs to Know,” to help physicians begin an effective nutrition conversation with patients. The four-hour, self-paced course is developed and hosted by the Gaples Institute for Integrative Cardiology, a nonprofit focused on enhancing the role of nutrition and lifestyle in health care, and is distributed in collaboration with the AMA Ed Hub.