DEAR DR. ROACH: I’m prediabetic. I have known you and others to say not to eat any grain that is not whole wheat. Based on that, I leave off white rice, pasta and white rolls. I eat two whole-wheat rolls most days. Does that sound right? I am underweight. — S.R.
ANSWER: It is much better and easier to prevent diabetes than it is to treat it. Diet and exercise are proven to help prevent diabetes in everyone, even your lesscommon situation of being normal or underweight and at risk for diabetes.
The most important part of diet is to avoid simple sugars. Processed grains are converted extremely rapidly to sugar in the body. The added fiber and protein of whole grains slows this process down somewhat; however, I still would recommend having your grains with some healthy fat and protein. Nuts, olive oil and healthy vegetable spreads go great with whole-grain rolls and slow down absorption. By having foods in combination, you can reduce diabetes risk.
Don’t forget about exercise, the other key to preventing diabetes. Any exercise is better than none. Walking is a great form of exercise that takes no special equipment and can be done anywhere. At 10,000 steps a day, which is not very hard to build up to, the risk of diabetes is significantly decreased. An inexpensive pedometer can keep track of your steps and may motivate you to reach your goal.
Diabetes has become epidemic in North America. The booklet on it provides insight on its diagnosis and treatment. Readers can order a copy by writing: Dr. Roach — No. 402W, Box 536475, Orlando, FL 32853- 6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: I have been taking Zoloft for almost 10 years now. My psychiatrist believes I should stay on the medication for the rest of my life due to three serious episodes of depression. Now that I go regularly for counseling, I am starting to see the root of the depression and am aware of the triggers. As I get older, I worry about the long-term effects of this drug. Are there any studies about long-term effects of Zoloft and similar medications? I’m also interested in your view on the necessity of anti-depressants as a permanent solution for people with my condition. I’ve read that antidepressants are not proven to be better than placebos. — N.M.
ANSWER: Depression can be a terrible disease, but for most people there are effective treatments. Zoloft is in the class of medications called SSRIs, and these work in the brain where nerve cells communicate with each other.
There are some studies and a lot of experience with using these medications long term. They are mostly safe, better than placebo and certainly better than the risk of recurrent depression, which after three episodes is very high. Counseling (psychotherapy) is another effective treatment. Effective counseling may reduce the risk for recurrent depression, but I would not stop the medication without being carefully followed by your counselor and psychiatrist.