Diabetes Prevention Unveiled: Real Talk on Diet, Exercise & Health

Rich Bennett 0:00
So we're sitting here with a bunch of strangers that I haven't seen in God knows how long, because the one never calls me or makes me do anything or just totally ignores me. Sorry, Miss Sarah, Not you. 

Kristen Perry 0:14
Thank you. 

Rich Bennett 0:16
Sitting here at the Harvard County Health Department. And today we are going to talk about something very, very important, diabetes prevention. 

And it's weird that this comes up today because I just got my blood work done, and now I'm in the pre-diabetic stage. What was the agency say when she was out? 5.9. So, of course, doctor tells me you go on. Well, first he recommended that injection thing, which is not covered under George. 

Kristen Perry 0:49
Okay. 

Rich Bennett 0:50
As the pharmacist has so 1400 problems. No, the other one will go. No, no, no. 

James Zone. I don't know. What? No. 

Kristen Perry 1:03
No. 

Ronya Nassar 1:03
There's like, a pill, a or something. 

Rich Bennett 1:06
The. I don't know it. I think it began with C, but anyways, looks like I've rather tried diet first and anything the side effects on a woman. There's a he said low calorie diet, which I'm doing because I definitely don't want type two diabetes. Nobody does or type one. So we're going to be talking about that today. We're going to go around the table first and let everybody introduce themselves. We'll start talking about. 

Salma Cavallo 1:29
Okay, I'm Salma Cavallo. 

Rich Bennett 1:31
And what do you do. 

Salma Cavallo 1:32
Here? I I'm a diabetes prevention lifestyle coach. 

Rich Bennett 1:36
Oh, are you want to know? Yeah, 

I. 

Salma Cavallo 1:43
Like. 

Rich Bennett 1:44
I would say that's one of the apps they recommend, which apparently my insurance covers and you get assigned to coach. I just started that this week. Okay. I'm loving it. You for really loving it. 

Kristen Perry 1:57
Yeah. I'm Kristen Perry. I'm a dietitian here at the health Department. And I'm also a diabetes lifestyle coach. 

Rich Bennett 2:03
A dietitian. 

Kristen Perry 2:04
Yes. 

Rich Bennett 2:05
Yes. All right. That's another podcast we have to do. Should we about it? Can we do that one time? 

Kristen Perry 2:09
We could. 

Rich Bennett 2:10
If you want. I thought about that. The other day about nutrition and everything. 

Kristen Perry 2:14
Yes, absolutely. 

Sarah Will 2:17
My name is Sarah. Well, I'm the communication specialist here at the health department. 

Zach Macas 2:23
I'm Zach Marcus. I'm the health policy analyst. 

Rich Bennett 2:25
And Rhonda works for you, right? 

Zach Macas 2:27
Yes, of course. 

Ronya Nassar 2:28
And Zach also oversees the diabetes prevention program grants Crohn's disease. 

Rich Bennett 2:34
Oh, okay. 

Zach Macas 2:35
I just do like the reporting and all that stuff. Yeah. 

Rich Bennett 2:39
Yes. You have to introduce yourself. 

Ronya Nassar 2:41
Hello. I'm into Sara, the director of Population Health and the Public Information Officer. 

Kristen Perry 2:45
It's been a long time coming from who you are. 

Ronya Nassar 2:48
Yeah, they probably hear out my voice, too. 

Rich Bennett 2:50
Yeah, I'm sure 

you're not going to sit there on my. 

F2 S7 2:55
Hands or while I'm the epidemiologist. 

Salma Cavallo 2:58
I tell you how many. 

Rich Bennett 3:00
Ways that we can. 

F2 S7 3:01
Or an 

epidemiologist at the health department. 

Rich Bennett 3:04
At what? 

Ronya Nassar 3:07
To at the. 

Kristen Perry 3:08
Allergist. 

Rich Bennett 3:09
What is an. 

Kristen Perry 3:10
Epidemiologist. 

Ronya Nassar 3:11
You personally among a bunch of things. 

F2 S7 3:15
Mostly like looking at numbers like data. 

Kristen Perry 3:18
For the county statistics for like any kind of all around health data. 

Rich Bennett 3:23
That's that that's what whatever you said does. 

F2 S7 3:26
Yeah, normally it's more like statistical analysis, but. 

Rich Bennett 3:30
I've never heard that term. 

Ronya Nassar 3:31
Really after COVID, you've never heard the term epidemiologist. 

Kristen Perry 3:35
Know how. It's interesting. 

Rich Bennett 3:37
Should I have? 

Kristen Perry 3:38
Oh. 

Rich Bennett 3:39
You've never brought it up really? 

Ronya Nassar 3:42
Well, I mean, it's not really like a general term. I could name the of 40. Yeah, well, it's really valid. 

Rich Bennett 3:47
Yeah, that's what he is. 

Kristen Perry 3:49
Yeah. Yeah. 

Rich Bennett 3:50
Did he ever say that. Whenever he. Yeah. 

Ronya Nassar 3:53
Well it's a it's a tricky word, but as an epidemiologist my parents going said. 

Rich Bennett 3:58
Yeah, I'm not even going to tell you you're going to try to die. Betis prevention. I guess the first question I have is explain to everybody how this ties in to public health. 

Ronya Nassar 4:16
We'll think about it's prevention. 

Salma Cavallo 4:17
Well, it's very common and it's increasing, you know, within our populations, especially populations. The population that I deal with, I'm I work with Hispanics. So it's it's a growing trend among people. And it has to do with our diet and lack of exercise. 

Rich Bennett 4:38
It's diet. And I explain this part to me because when it comes to the a lot of it was diabetes. And I don't know if it's a myth or what, but a lot of people say it's caused by too much sugar. 

Kristen Perry 4:53
It can be. 

Rich Bennett 4:53
It can't. 

Kristen Perry 4:54
Be. It can't be too much sugar. It could be lack of exercise. Right. Yes. It's it's a combination. It's a complete lifestyle. How you live, everything that comes together that will increase your numbers. I wouldn't say it's just one thing. 

Rich Bennett 5:08
Okay, Now it is. But it's also hereditary, too, right? 

Kristen Perry 5:13
Yes. 

Rich Bennett 5:14
Both times. Type one and type two. 

Kristen Perry 5:16
Well, type one is more. It's autoimmune. So I wouldn't really necessarily say it's hereditary, but they both can be autoimmune, meaning something. Attack the pancreas two way or your pancreas no longer can produce insulin. That's type one. So there's a complete difference. Whereas type two is typically what they call adult onset or okay, that's usually related to diet and lifestyle. 

Rich Bennett 5:41
So but you can be any age, you can either type, right? 

Kristen Perry 5:44
Correct. 

Rich Bennett 5:44
Okay. Yeah. 

Ronya Nassar 5:46
And you say you also have gestational diabetes. That's the other. 

Kristen Perry 5:49
Yes. The white. 

Ronya Nassar 5:50
Gestational diabetes. 

Rich Bennett 5:52
What is it? 

Ronya Nassar 5:52
That's the diabetes you get when you're pregnant. 

Kristen Perry 5:55
Yeah, when you're pregnant. And that also increases your risk for type two diabetes later in life. 

Rich Bennett 6:00
Oh, wow. 

Kristen Perry 6:00
Yes. So there's many different risk factors that affect type two diabetes. 

Explain your age, race, physical activity, Um, again, gestational diabetes, um, hereditary as well. Your genetics, um, parents, grandparents. 

Salma Cavallo 6:21
The BMI greater than 25, which is your body mass index. 

Kristen Perry 6:26
Yes. But your age in itself like once you hit 45, that already is one point towards your BMI. 

Rich Bennett 6:34
This is where I get confused is your BMI appears to be higher low. 

Kristen Perry 6:37
Lower. 

Salma Cavallo 6:38
Level better. Yeah. 

Rich Bennett 6:40
Okay. Because I mean like a lot of your bodybuilders have you'll be amazing I guess higher right? Right. But they can be the same weight as me in mine could be lower or whatever or but I'm I'm not in the same shape. Is that. 

Kristen Perry 6:56
There? It depends. So your BMI is based off your age, your height and your weight. 

Rich Bennett 7:00
Okay. 

Kristen Perry 7:00
It has nothing to do with your activity level. So you're right in that a bodybuilder, their BMI could be higher. Mm. 

Because they are more muscular. So they are going to weigh a little bit more Muscle does weigh more than fat. 

Rich Bennett 7:13
Right. 

Kristen Perry 7:14
But age is a big indicator too, into your BMI. So your BMI is one of the predictors. However it's not the be all end all because there is some research into saying BMI is not the only thing. And do we really want to focus on BMI as your health indicator? In my opinion, is no right. I like to look at overall, what is your lab work look like when your activity level? There are two big indicators as far as your health steps. 

Rich Bennett 7:41
Okay, So all right, like with me, when I go to my I go to my doctor once a year, they do all the blood work right now with the health department. If somebody comes, if they qualify to come in to get checked for diabetes, does the health department actually do the blood work every year? Or how does that work? 

Kristen Perry 7:59
I don't believe the health department does. Okay. Yeah. 

Ronya Nassar 8:02
They usually they would have to go to their doctor for that. Yeah. To get their test of like if they whether it's a blood test or whether they get, you know their you won't see finger prick finger prick. But they unfortunately like not here at the health department. Get that test. 

Salma Cavallo 8:17
You guys know if you join a diabetes prevention program. We do partner with the University of Maryland. They're a nurse, one of the nurses there. And she does check on the first and the last visit. I don't know for you Tested? Yep. Yeah, Yeah. 

Kristen Perry 8:36
So they'll check your agency to a one second site. 

Rich Bennett 8:39
All right. Tell us about this program, because I didn't know there there was a program that you guys are doing with the University of Maryland. 

Salma Cavallo 8:45
Yeah. 

Kristen Perry 8:46
So the Diabetes Friendship Program, it's it's a year long lifestyle change program that was developed by the CDC back over 25 years ago. So it's a year long program because we want to we want people to make those lifestyle changes. Right? So with that, it comes time. The way the program works, the first six months of the program oh, I'm sorry, the first four months of the program, we meet once a week. So that way we can establish the foundation, teach them the skills that they need for this lifestyle changes. Then months four through six, we meet every other week and then months six through 12 we meet monthly. So there's 26 sessions all together. 

Rich Bennett 9:27
You meet in person. 

Kristen Perry 9:28
We meet, but we're virtual. Okay, So it depends on which type of cohort you're assigned to, right? I've had two cohorts that were complete 100% in-person, and I'm doing the two I have currently. They're hybrid, so majority of them are virtual. 

Rich Bennett 9:44
How long's the program been around? 

Kristen Perry 9:47
Like I said, the CDC developed it over 25 years ago. Now, as far as upper Chesapeake, they have been doing it for, I want to say, ten plus years. 

Ronya Nassar 9:55
I would say virtually year, because they were really I say where we were six years ago and six years ago they were like, really? Like it's yeah, I think it's around ten years. 

Kristen Perry 10:04
Wow. Yes. Yes. And it's a free program. It depends on, you know, your location, where you're at. But here for our county, it is a free program through the upper Chesapeake, whereas other states and other counties you could go to where you might have to submit your insurance, But we don't make you do any of that. We just have you fill out the registration form. We don't take your insurance information if you don't provide it. Right. And like I said, it's free. 

Rich Bennett 10:32
Okay, So where can people go to to find out more information about that? 

Kristen Perry 10:36
You can go on to either our health department Web site and we have links for registration. Okay. Or upper Chesapeake website to register or they can call to register. 

Rich Bennett 10:47
How if you don't mind me, who has a role in on that? Because we as I mean, I'm sure diabetes is going up and not down right. So how's enrollment on that so far? 

Kristen Perry 10:57
I mean, so far, our registration, once we put out a registration for the programs, they're filling up within a few days. Really for participants? Yes. 

Rich Bennett 11:07
So you can only take so many participants. I guess. 

Kristen Perry 11:10
We can. So we cap it. We'd like to cap it at 15. 

Rich Bennett 11:13
Okay. 

Kristen Perry 11:14
Just so we can really because a lot of it is peer support. So, you know, it's only a one hour session. So there's there's that many people and a lot of people talking. We've got to keep it focused. 

Rich Bennett 11:24
So I tell you what you do as a dietitian, there's a lot you have to offer. 

Kristen Perry 11:29
There is. And there's a lot of questions that come about. So we do get off track a little bit. But the questions that they ask are really good questions. 

Rich Bennett 11:36
What are some of the best questions you've heard? 

Kristen Perry 11:38
Oh, my goodness. 

Rich Bennett 11:41
Well, I ask that because a lot of people when when it comes to diabetes, especially if they're diagnosed, it's like anybody, even if they're diagnosed with cancer right away, they they can't think of the questions because they get that scare factor. 

Kristen Perry 11:56
Right. 

Rich Bennett 11:58
And I know with me before, I've had a lot of questions, and now that I'm pre-diabetic, it's like a lot of those questions are coming out of my head. 

Kristen Perry 12:07
Right? Right. It will. And just like you said, your levels are high and your doctor just told you will go on a low calorie diet. Yeah, well, you leave there thinking, okay, what is that? Ideally so so. 

Rich Bennett 12:21
It's low cal. 

Kristen Perry 12:22
So that's where some of the questions come up. I mean, if we start talking about exercise, then some of the questions might be what kind of exercise should I do? Or if it's diet related questions, you know, I'll start mentioning some foods and foods with protein, and it could be questions of, well, what, what protein, what can I have? And some people it's a matter of they'll say, well, I eat, you know, I eat beans or I eat, you know, peanut butter. Well, peanut butter is not a protein, But what peanut butter is not a protein, even though peanut butter has protein in it, you know, in our food source, not considered a protein. So these are some of the things that come up with in our class. And we go and kind of we get off course a little bit. 

Ronya Nassar 13:05
I would say, too, I think the hardest thing I you know, Kristen teaches diabetes prevention program in English. Selma teaches it in Spanish. So she even has like, she has like some harder questions to because you're used to a culture with a certain diet. So then they're going Selma and now she's working with. Yeah, okay. Well, how you know, trying to explain, okay, now you're here. What do we what how do we talk about, you know, the diet in like, you know, control because you don't want them to stray away from what you know, they do. Yeah, but how do you make it healthier? 

Salma Cavallo 13:35
So, yeah, so, so for example, in the Hispanic culture, you like your rice, beans and meat. A lot of the meats that they will eat are saturated or saturated fats, you know, And so just teaching them to limit their portions, first of all, and then eventually, if they can, to substitute that rice for Kinlaw, which is a grain with less carbohydrates and more protein. So, you know, these little changes, integrating more soups rather than soups. Yeah, soups that are lower in calories than rice and beans. And in your regular typical cultural dishes that Hispanic like. So anyway, just stop. Yeah. Yeah. My plate is a big deal. In our program, we discuss the recommendation, the portions we teach reading labels so that they recognize the high sodium that leads to hypertension, 

saturated fats leading to high cholesterol, which is all part of this metabolic syndrome that we deal with when we're teaching these classes. So so those are just some of the some of the items that we discuss, which is all part of the Hispanic diet as well. 

Rich Bennett 15:00
That's kind of be hard because I, I mean, I'm looking at calories now. I never even thought about looking at the sodium and all of that. I'm just organic, low calories. And now I'm upset because you said peanut butter is not a protein. So you mean to tell me I haven't had to add that to my smoothie all the time. 

Kristen Perry 15:20
I'm going to add calories and fat. 

Rich Bennett 15:23
Yeah, well, you are worried. 

Kristen Perry 15:25
About. 

Rich Bennett 15:26
Like, nuts because we're eating walnuts a lot, which are a very helps if you're brain health, but they're very high in calories. 

Kristen Perry 15:34
They are. So it's a fat. But it's a good fat. Okay. If anything, though, you don't want to have too much of it, even if it's good. So we teach over it. We go over serving sizes. So we do incorporate nuts because walnuts, like you said, they're great anti-inflammatory and they're really good for cardiovascular health. However, we'll teach them, you know, make a cup size in your hand quarter cup. It's a serving. Okay. That's about how much you should have of nuts. 

Rich Bennett 16:00
The with the low carb diet and this is where I this is where I get confused. What is what's the you have to have so many calories per day. Yes. What is the for women and for men? What is the recommended? I mean, because you don't want to go below a certain amount. Right. 

Kristen Perry 16:21
So I wouldn't really say there is a recommended amount for either one. Okay. Generally, whenever you're looking at a nutrition facts label, most of what's on there and I'll say based off of an 800 calorie diet, so that's the general. So that I kind of fit many people. Okay. But again, it depends on your age, your weight, your height and your activity level as far as how many calories you need. So and then do you need do you need to lose weight or do you need to gain or you have to maintain? So it's all it's different for everybody, but whatever. Yeah, I mean, if you're ever talking about weight loss, the whole idea is you need to be in a calorie deficit, which means you need to be taking in less than what your body needs as the only way you're going to lose weight is if you put yourself into a calorie deficit. 

Rich Bennett 17:07
And you start walking. 

Kristen Perry 17:08
Along. 

Rich Bennett 17:11
Louis Fraser I need to start walking. 

Kristen Perry 17:13
Period. 

Rich Bennett 17:14
Without that. Oh jeez. 

Kristen Perry 17:16
Walking is great. Oh yeah. 

Rich Bennett 17:18
It it allowed people to realize that even see, it could be very wrong. But even because a lot of people like me, I sit down at my desk more and more now, but even just I see some of those things you can put on your desk like a pedal thing. 

Kristen Perry 17:31
Yeah. 

Ronya Nassar 17:33
That's smart. I trust Ami considered it. If I want a walking. 

Kristen Perry 17:36
Pad of. 

Rich Bennett 17:38
A once. 

Ronya Nassar 17:38
Walking pad. You see those two walking pad? It's like a journal. I don't like to see it, but it's usually a little bit smaller. 

Kristen Perry 17:46
So I was going to buy one bring upstairs. 

Rich Bennett 17:47
And you can put it under your desk. Yeah, And that's good exercise. 

Kristen Perry 17:50
Yeah. You can walk up to $50 on and in my cart. I just keep it in your last attempt. It is has I get emails coming in. Where are you. 

Rich Bennett 18:01
Look something like that would be I guess a double benefit because you're helping yourself, you know with the exercise them becoming diabetic. And let's face it, if you sit down too long and you go right in development, You hear that? 

Kristen Perry 18:18
Yes. 

Rich Bennett 18:18
Yeah. So keep it a moving. 

Kristen Perry 18:20
Yes. Which is why I say if there is an option, like you were mentioning under the desk, kind of like a bicycle in your know, whereas they were talking about the walking pad where they're up though, so they're standing up and you'll be sitting down. So it's if you have a choice, one or the other, I would say make sure you get up because you have better blood flow where you tell me that you standing. 

Rich Bennett 18:39
Behind your desk and do that. 

Kristen Perry 18:41
Thing, walk up to the treadmill. I do you I mean, yeah, that's a button. And that you'll be doing a bicycle. 

Yeah. 

Rich Bennett 18:49
So I'm so now I need to get the elevated desk. 

Kristen Perry 18:52
Yeah, Yeah. 

F2 S7 18:53
Just come join us at the. 

Ronya Nassar 18:54
Harbor bell every day. Yeah, for 30 minutes we go online. 

Kristen Perry 18:59
And we go over that in our class. That's part one of our sessions is to take exercise groups to get up and move every 30 minutes, get up and move for 2 minutes. So we talk about that, but I mean, as far as movement goes, you need to get up and move the moves, the blood sugar within your body. So the blood sugar, the food you're taking in that sugar is getting moved into your muscle cells where it's need of energy. 

Rich Bennett 19:22
All right. So when it comes to diabetes, what are some of the biggest myths out there? 

Kristen Perry 19:29
Because myths. 

Salma Cavallo 19:33
The artificial sugars. Yes. Artificial sugars are good and not necessarily, you know. 

Kristen Perry 19:42
And. 

Salma Cavallo 19:43
Yeah, that's one of the aspartame is one of the worst ones. And then like, for example, drinking a Diet Coke versus a regular Coke. Yes, there's less sugar and that is going to reduce your calorie intake. But at what cost? The aspartame is really not the best sugar substitute and the body doesn't recognize that that sugar is a substitute. So it will convert to calories, convert well, fat in the liver. Still. 

Kristen Perry 20:14
Knowing that it's your sweeteners, your artificial sweeteners are more sweet than regular sugar, which means your body is getting used to that sweetness. So you're constantly chasing that sweet. So once you're done that Diet Coke, say it's, you know, 2 hours later you're wanting something else. You're wanting something sweet again. And so a lot of people will fill up on, say, those, you know, non-nutritive calories to where they're not really getting the nutrients that they need because they're filling up with these sweeteners all day long. So they're just filling themselves up. But you're not getting the nutrients you need. 

Rich Bennett 20:48
Like I use, what is it, 

stevia in the. 

Kristen Perry 20:52
Roll clear. 

Rich Bennett 20:53
Now, which is their extreme stevia and stevia. And they're all. 

Kristen Perry 20:56
So stevia stevia, the actual plant, the extract is just pure stevia, which is just, you know, an herbal sweetener, all natural sweetener, whereas some of them have the I think it's called I'm not going to say this right, but stevia, I all it kind of ends in EOL, which means it has a chemical to it. So it's bound to a chemical to make it even sweeter. Okay. You're not getting that. Just the pure stevia. So if you had a choice between the two, you definitely want just stevia. So you look at the label, just pure stevia. 

Rich Bennett 21:30
Okay. All right. 

Kristen Perry 21:31
So trivia and things like that you see on the grocery shelves. Yeah, that has the added chemicals to it. Yeah. 

Rich Bennett 21:36
Oh, yeah. Okay. Yeah. Because I know I was doing what was it, the monk fruit 

that apparently is not good for you. 

Kristen Perry 21:45
So that's right. In line with stevia. 

Rich Bennett 21:46
So. Okay. 

Kristen Perry 21:47
Monk fruit is actually a kind of stevia. I had, you know, it was on the rise years ago and now monk fruit is the competitor now to stevia. Okay. But still, it's the same. But people will use that because of the high temperature. You can use that so you can cook and bake with it. 

Salma Cavallo 22:04
And so our program is really not a diet. We don't consider it a diet. We just pretty much the program educates people instruction on, you know, what you can do to substitute. And if monk, fruit or stevia is your choice of sugar, that's good. But we just ask that you limit. 

Rich Bennett 22:25
Your right. 

Salma Cavallo 22:26
And then eventually try to wean off it, if you can, for a drink or two during the week, you know, just to reduce the calorie and the sugar intake. Yeah. 

Kristen Perry 22:37
Yeah. But I mean, back to your thing. I think what you mentioned about with diabetics and maybe they do and the myths. 

Ronya Nassar 22:44
I think a lot. 

Kristen Perry 22:45
Of, you know, counting counting your carbs and your sugars 

and really and then they take the medication. Some people who are on medication, you know, they'll eat what they want and they think that they can take their medication because it's going to offset their numbers. 

Rich Bennett 23:02
But not the case. 

Kristen Perry 23:03
No, no, no. Because inside what you're doing inside is you are damaging your insides because you're not helping yourself and you're still taking your medication. You're still eating those foods, which is really you're throwing your levels way up and then you're taking your medication to lower it down. You're not teaching your body natural ways to do that. Okay. Which is eating a balanced diet. And as Sam said, we teach the plate. So making sure it's for the diabetes plate method, we can say half of your plate fruits and veg or half your plate vegetables. Mm. A quarter carbs and a quarter protein. And with the diabetes plate method, we say vegetables because fruit is a carb the way that your body takes it in. So as far as when you have a quarter of your plate being carbohydrates, we link fruit into that carbohydrates with that. 

Rich Bennett 23:56
Do you recommend that people go to a smaller plate? Because, you know, I mean, others dinner plates are big, you know, whole tomahawk. Yeah. They go. 

Kristen Perry 24:04
Yeah. 

Rich Bennett 24:05
I mean, does that seem to help you go to a smaller. 

Salma Cavallo 24:07
Smaller nine inch plate? 

Rich Bennett 24:09
A nine inch plate? 

Kristen Perry 24:10
Yeah, yeah, Round, smaller plate. And then that's another thing that we talk about. In addition to the plate, we go over serving sizes. Right. What is a serving size right. 

Rich Bennett 24:20
It's something I didn't notice really threw me off. When you look at your packages and says how many calories? Yeah, I didn't realize that. Were you that that's the calories in the serving size. Right. 

Kristen Perry 24:33
Right. 

Rich Bennett 24:34
I thought it was in the whole bag. So I was doing good. 

Kristen Perry 24:37
You lived in the big world, right? Yeah. 

Ronya Nassar 24:40
It's like 100 calories for a whole thing. 

Kristen Perry 24:44
Always with. 

Rich Bennett 24:45
The funny thing is that when you look at the serving size, it doesn't seem like a lot. Like with the walnuts. And then when you fill up that cup, third cup, whatever it is, it put it on your plate. So that's it's still a good amount. And I think through a lot of people, because a lot of people are used to just holding the bag or something and 

like with me the other day, cream before I got the results right, we got a quart of ice cream. It's like you take one bite and next thing you know that it's gone. Yeah, it was good Salted caramel ice cream. 

Kristen Perry 25:22
Could I say it with you? Right. 

Ronya Nassar 25:26
You know what kind of ice cream it's like? 

Kristen Perry 25:28
Yeah, and it actually. And that's the other thing that we do teach in the class is, you know, we're not telling you that these foods are off limits, right? So it's just, you know, you can have the ice cream. You just don't have the whole container of ice cream. 

Salma Cavallo 25:41
Yeah. Don't bring the whole container or the whole bag of chips with you, you know? 

Kristen Perry 25:46
So take it out, put it in a bowl. And what I tell people a little trick is I still have my kids cups, kid sized plates, bowls, cups. You know, IKEA has really good kids dinnerware. So if you're going to have ice cream, you get a kid's bowl and you put it in there. 

Same thing. That's a good idea. Kids size. 

Salma Cavallo 26:10
Yeah. Yeah. It's a psychological effect, right? That's I always use it. Yeah. Small plates. Yeah. I think another myth is understanding the agency. People think diabetics think that, well, I'm going to behave this week so that my 81c when it's check tomorrow is is going to be fine and that is a mess because the A1 C is actually how saturated each red blood cell is with the amount of glucose that you've been eating in the past three months, which is the life cycle of a red blood cell. So. So yeah, yeah. That number actually reflects an average of the past three months, how well you've behaved or how bad that's as far as your diet. So yeah, yeah, my mom used to do that all the time and I told her mom that one day one meal isn't going to make a difference, right? 

Ronya Nassar 27:04
It's like the people that think, Oh, I'm going to go see the dentist tomorrow, let me floss today. 

Kristen Perry 27:09
So that I can make up for the past six months of the same thing. It's like the same thing with diabetes. 

Ronya Nassar 27:16
Is like, let me. 

Kristen Perry 27:17
Help me today. I'm going to get me one. Oh, yes. Yeah. 

Rich Bennett 27:22
Healthy. Should you check your 81 Cheeto? I mean, I know, like, if me is once a year, we're not. Get the blood work done. 

Kristen Perry 27:28
If I were you, I mean, I would ask for it every six months. 

Rich Bennett 27:31
For the blood work. 

Kristen Perry 27:32
Yeah. Yeah, as long as your insurance will cover it. And, you know, but some younger people don't realize, too, is with your doctor. You have to request the agency to be on your blood work. It's not just going to be on there. Now your glucose, your fasting glucose will be on there. But they won't check for they won't see. So you do have to request that. But I would check it every six months because, you know, as Salma said, it's it's a marker of three months, you know, free agency. So this way here, we're getting that midpoint. You don't want to wait a whole entire year to see if your levels are going up or down. 

Rich Bennett 28:02
Right. 

Kristen Perry 28:02
I think if you need to make that change, that good six month mark, it's a good area. 

Rich Bennett 28:06
I didn't realize with FDA when see it came. So you can't cheat the system. You can't you can't cheat your system, I should say. Yeah. 

Kristen Perry 28:15
Why don't you school with like you're marking period. Great. You know, you're great. You know, you can do really well on a quiz, you know, the night before you can cram and you can study for it and do well on it. But right at the end, when I give you that final, how are you going to do it? 

Rich Bennett 28:28
It's just like, what do you want to eat? That average number is good, not the high number. 

Kristen Perry 28:32
Or the number you got to put in the word all marking period long. Wow. Yeah. 

Rich Bennett 28:37
I got a lot of work to do. So wonders, what are some other myths out there? Because I know what I mean. With diabetes, you always hear so many different things, but then you hear the opposite. It's like somebody would say, This is good for you. Oh, no, that's not good. Prime example, like with the diet, with eggs. Very well. What? 

Kristen Perry 28:57
No, eggs are good. 

Rich Bennett 28:58
Okay, you have that look like, God, no. 

Kristen Perry 29:01
Eggs are great. Are not going to raise your cholesterol. Okay? No, cholesterol. 

Ronya Nassar 29:06
Doesn't raise your cholesterol. Right. 

Kristen Perry 29:07
Your eggs Do not raise your cholesterol. I'm sorry if I said that wrong. 

Salma Cavallo 29:10
And avocados. Yeah, avocados are great, too. I try to integrate that into my lessons to avocados that I'm. 

Rich Bennett 29:19
You guys have lessons online? Like, do you do like webinars and all you do webinars? 

Salma Cavallo 29:24
No, we do. Was virtual with my groups, my Hispanic groups. It's all virtual. We have people coming from the Baltimore area, not necessarily Harford County. So it's more convenient to do these virtually, except the first and the last where they're a onesie is being checked on site. 

Ronya Nassar 29:43
I just want to throw out there, you sound like a really great candidate for their diabetes prevention program. I think you would benefit from it probably. 

Kristen Perry 29:51
And I think this would be I think this is a concern for you to hear. 

Rich Bennett 29:55
But as with a lot of things for with the health department, do you have to qualify for it? 

Ronya Nassar 30:02
You know, necessarily have to qualify with what you've been saying? 

Kristen Perry 30:07
You technically. 

Ronya Nassar 30:08
Qualified, you'd be grade. 

Rich Bennett 30:10
One? I have no idea. 

Kristen Perry 30:13
Like, there's no there's no income guidelines. 

Rich Bennett 30:16
Okay. 

Kristen Perry 30:17
No. 

Rich Bennett 30:18
So it's not like everything else over a lot of the other programs we talk about. 

Kristen Perry 30:22
And in fact, I mean, there are qualifications for the program as far as I know, your agency should be in that range, which is 5.7 to 6.4. 

And again, it's you take the test, you can go on the CDC website. It's you know, it's take the test and there's questions on there. And if you score, I can't remember seven or above five or either or you can qualify. However, upper test speak makes it very, very flexible to where if you are interested and you want the information, we will let you in the program. Now, we just won't be able to use your information or report that to the CDC. But you are more than welcome to come to the class and receive the information. As long as you're 18 or older. 

Rich Bennett 31:03
How come you can't report any information to the CDC. 

Kristen Perry 31:05
If you don't qualify as far as scoring that five or above? 

Rich Bennett 31:08
Oh, okay. Go check. 

Kristen Perry 31:09
The test. We just won't report your information. 

Ronya Nassar 31:13
They won't say no. They won't say no to anybody. Yeah, right. It's beneficial, it's educational. And like they said, you know, it doesn't matter who you are in every county, you can, you can take the class. And sometimes they say it's also beneficial. See if there's someone like a husband there who has a high one. See? Well, maybe it's beneficial to the husband or like, do the class together, even though the wife might be okay. Maybe have her husband or wife do together. Because like they said, it is a class that is really good for, you know, peer support to that. And, you know, if having your spouse or having your friend go with you, like that's just the best peer support that can lead you on a four year journey and then you don't feel like you're doing it by yourself. You have you have someone with you. So it's a it's another option actually. 

Rich Bennett 31:56
Speaking of peer support and outside of the program, are there support groups with that? You know, of people that have diabetes? 

Kristen Perry 32:05
Yeah, I participate grants programs there is Yep. 

Salma Cavallo 32:09
So I mean about to start a Spanish one. 

Kristen Perry 32:12
Really? Yeah, yeah, yeah. There's diabetes self-management program. 

Salma Cavallo 32:17
It's all on their continued education website right. Yeah they have a calendar. 

Rich Bennett 32:22
I just because we do support groups. Well we did it with addiction. 

Kristen Perry 32:26
Yeah. 

Rich Bennett 32:27
There's people together and talking. Yeah. It just because then more people have more questions. 

Kristen Perry 32:34
Yeah more questions generates ideas you know, people are stuck in a rut. It just gives them ideas. 

Rich Bennett 32:40
With the diets. And this is where I get confused because, you know, like if they want to start and I just started this week, but the low carb diet, I'm strictly looking at calories. But apparently you also got to look at saturated fat protein, all this stuff. Yeah. 

Is there like certain things that you should stay away from? And what I mean, that is like a lot of your frozen meals have there additives. Yeah. 

Kristen Perry 33:11
So they're going to be more of your processed foods so they are typically higher in sodium. Yeah. And then what I consider you know, there's inflammatory foods. So anything that's already made for you processed, that's kind of an inflammatory food. So that's going to increase your blood pressure. You have the higher sodium content. 

Rich Bennett 33:31
Okay. 

Kristen Perry 33:32
The one tip that I like to tell people is I like to tell them to work on pairings. So protein the always pair protein, so protein and carbohydrates protein and produce. So focus on that. If you could focus on the keywords, pairings, protein. 

Rich Bennett 33:47
Okay. 

Kristen Perry 33:49
So while you're say for instance, if you're having breakfast, some people will say, well, it's great. You know, I have I have oatmeal. Okay, What do you have with your now? Because your oatmeal is a carbohydrate. So maybe to pair that with a protein, how about can we add some milk in there? Can we add hardboiled egg in there? And because pairing that with a protein is actually going to make it harder for your body to digest it. And that's what we want, where you want your body to work harder to digest it. 

Rich Bennett 34:14
I can't find it now, but I found something that I did put it about my progress and now I can't find it because you know what I'm doing? It's telling me for weight loss to stay in between God and my waist. At this time, between 

2370 and 3120 calories a day. But then I didn't realize we when I pulled it up after I checked in of four over here you go to of like with the green foods, yellow foods, orange it's what is all that stuff. Yeah. 

Salma Cavallo 34:52
We say eat a rainbow, which typically just means adding lots of color to your plate, which will include your bell peppers, tomato and green. 

Kristen Perry 35:03
Yeah. Different. 

Rich Bennett 35:05
Oh, okay. 

Sarah Will 35:05
Green is like. 

Kristen Perry 35:06
Fruits and vegetables. 

Ronya Nassar 35:08
Sort of like. 

Sarah Will 35:08
Oranges. Like. Okay, moderate and red is that. I don't eat. 

Kristen Perry 35:12
That. Oh, okay. Yes. Different. Everything. But that's maybe like your stoplight color or. 

Rich Bennett 35:19
Go back to the rainbow thing. 

Salma Cavallo 35:21
That's interesting. You just eat a rainbow. Meaning have half of your plate back to my plate. Half of your plate full of veggies, which are yellow squash. Right. You know, your veggies and then your meats and your proteins, your proteins, which is your meat and then your starches or carbohydrates. Yeah, but the color comes from the veggies. Make sure you have sufficient cooking. 

Sarah Will 35:50
On your plate to be the. 

Ronya Nassar 35:51
Same. Yeah, well, it's like the American diet, right? 

Kristen Perry 35:54
Yeah. You're very up your calories. You get different vitamins and minerals. 

Salma Cavallo 35:58
And I think that brings up a different myth, too. I think diabetics, they feel like they can't have sweets or breads, and that is not true, right? We we encourage whole wheat grain breads. Dave's killer bread. I love that seeded bread. 

Kristen Perry 36:20
Is. 

Salma Cavallo 36:21
Dave's killer bread. It's in the frozen section. It's a seeded bread. 

Rich Bennett 36:26
It has frozen. 

Kristen Perry 36:28
I don't know. 

Ronya Nassar 36:29
Though. Aren't those like very like high in sodium or. No. 

Kristen Perry 36:34
That's a good question. So I'd have to look. 

Ronya Nassar 36:37
At the label because a lot of those protein ones are, for example, like the Kodiak. 

Kristen Perry 36:41
Pancakes. 

Ronya Nassar 36:42
Those are so high in sodium. So like certain like so you avoid those. 

Kristen Perry 36:47
Yeah, avoid them. I mean. 

Ronya Nassar 36:49
Calorie wise protein prices are. 

Salma Cavallo 36:51
Great, but if mine is more. 

Ronya Nassar 36:52
Of dealing with heart disease. Exactly. Yeah. 

Rich Bennett 36:56
Yeah. Kodiak pancakes. 

Kristen Perry 36:58
Yeah. 

Ronya Nassar 36:58
They're like a like the protein pancakes. Basically. You can get a mix. Yeah, they're just. 

Kristen Perry 37:03
They're just high in protein. Yeah. 

Ronya Nassar 37:06
The calories are pretty good. 

Rich Bennett 37:07
And Dave's. 

Kristen Perry 37:09
Killer had just. 

Rich Bennett 37:12
I mean, the killer part just doesn't sound. 

Kristen Perry 37:14
Right. 

Rich Bennett 37:14
I mean. 

Salma Cavallo 37:16
Yeah, I know. It is funny. He's. He's. It's his brand, so he gets to name it. Whatever. 

Kristen Perry 37:22
It's up to Dave. Yeah. Oh, yeah. Great bread has actually it has a lot of fiber, has more protein than regular bread. 

Salma Cavallo 37:29
Ezekiel Bread is another one that's really bad anyway. 

Kristen Perry 37:34
So the myth is. 

Salma Cavallo 37:36
No, you can't have your bread right. But within portion and within the less processed. 

Rich Bennett 37:43
Portion I guess it sounds like is the key thing. 

Salma Cavallo 37:46
Serving sizes? 

Kristen Perry 37:47
Yeah, absolutely. That I will say that's probably I want to say it comes in our third or fourth lesson of the program. And that's the one lesson when we give them, we give them food scales and we give them measuring cups and we go over how to read the food label and measuring out your food. I think after that lesson is usually the turning point for many people. Yeah, that's the lesson too, where they really start to look at the labels and look and see what they're putting on their plate. It's they realize, Wow, I was really overeating. I didn't realize this until I always measured out my food. 

Rich Bennett 38:18
Right? 

Salma Cavallo 38:19
And there's a 520 rule to within the program, which just means 5% is low 2%, 20% is is high. And so you're looking at you're looking at the labels and you're looking to see how much sodium is in there, what percentage of the serving size is sodium? You know, if it's five or below comes up, okay. If it's 20% or below 2630, that's too high. So same thing with the fiber or saturated fats, everything within that label. We you know, that's that's just a general rule that. 

Rich Bennett 38:56
You don't want high fiber. 

Kristen Perry 38:58
Now, you do want high one. So there's nutrients that you want to get more of, and then there's nutrition you want to get less of. So the nutrients, you want to get more of your fiber. Kelsey Magnesium, potassium. And usually they're kind of towards the bottom of the label. Okay, You won't get more of those. So 20% above, great. Then there's nutrients going to get less up, which is your saturated fat, your sodium, your added sugar, trans fat, which really is on the label, but there's really not supposed to be trans fat in our products anymore. But so nutrients get less of you want to try and 5% or lower is great, but you definitely want to be under 20. So that's the idea when you're looking at percentage on a food label. 

Rich Bennett 39:42
Okay. When you when you're cooking the foods. Yeah. And you see, you know, doesn't that add more stuff to it? How do you determine that? 

Kristen Perry 39:52
So so some of your seasonings, do you have sodium? Why do you shake your head at me? 

Ronya Nassar 39:55
No, I'm just I'm just thinking about like the foods we eat and. 

Kristen Perry 39:58
It's like, Oh, yeah, yeah. Oh, sorry. Good. Depends on what seasonings you're using. Okay, so some seasonings will be high in sodium. So you do have to watch for those. But like, there's there's a lot out there though, that are low sodium, like Mrs. Dash, they're going to be a little bit better for you. 

Rich Bennett 40:16
Because I never give you a lot of your meats. You're supposed to use a lot of salt to tenderize. Yeah. 

Kristen Perry 40:22
Right. You don't have to. 

Rich Bennett 40:25
Many that You don't have to, but I mean, it does make it taste bad. Yeah. Yeah. All that steak out. Let it sit for a while. Oh, my God. Something just hit me because no one on the podcast did about. And I got upset because. 

Kristen Perry 40:41
Cancer prevention. 

Rich Bennett 40:42
Yeah, that girl and food. 

Kristen Perry 40:44
Oh, yeah. 

Ronya Nassar 40:44
Yeah, yeah. 

Rich Bennett 40:45
So 

am I. 

Kristen Perry 40:49
Sold out the grill. 

Sarah Will 40:52
They're saying the grilling food. 

Kristen Perry 40:54
Causes cancer because. 

Rich Bennett 40:56
Of the high heat. Yeah. Yeah. 

Kristen Perry 40:58
Okay. And see, and I'm of the belief of you know grill or bake. Yeah. Okay. Air fry. 

Rich Bennett 41:06
So a lot of the recipes are the air fryer. Yeah. So a lot of recipes you can so grill and smoky Norma. 

Kristen Perry 41:13
I would say yes. 

Rich Bennett 41:14
The. 

Kristen Perry 41:16
Curative dietitian that's what I doing okay. Yes. I'm not talking about the cancer prevention side over the diabetes for me. Yeah. Okay. Yeah. Really bake it. And then also, too, you know, meats, chicken, things like that. Take it off. 

Rich Bennett 41:29
Joe. All right, well, what about salmon there? Because salmon, the skin's good for you. 

Salma Cavallo 41:33
Yes. Oh, one of them. Yeah, One of the recommended fish we recommend because of the high omega three content, which is the good fat. 

Rich Bennett 41:43
Is there is there a place where you could find, especially when it comes to fish, all the different types of fish, which would be better for you because around we have the blue catfish and we have I forget what they call now snakehead fish, but they gave it a different name to make it sound better. Oh, but is there anything where you can go to find out how many calories and omega threes and all that are in it? 

Kristen Perry 42:10
Honestly, I would just do a search anymore. 

Salma Cavallo 42:11
Yeah. 

Kristen Perry 42:12
Right line. Because I mean, the the fish that I always recommend my go to a salmon yellow salmon. 

Rich Bennett 42:19
Yeah. 

Kristen Perry 42:20
Just because of the omega three fatty acids that are in there, it's great for brain health and it's also one of those foods is anti-inflammatory. So especially as we age, heart disease. 

Rich Bennett 42:30
Arthritis, it's great when it comes to diabetes. Water. Yeah. How much water should somebody drink a day? 

Kristen Perry 42:42
My recommendation when I tell people is 100 plus ounces a day, and that's way more than probably what some people drink. Some people are so used to the 88, which is eight cups of eight ounces a day. So really that gives you only 64 ounces a day. 

I'm of the belief 100 plus. Okay. And you want to spread that out throughout the day. Right now, I want to talk it all at one time. 

But yeah, because that will actually help actually move the sugar throughout your body. So in that company, sugar levels are really high, right? That's one of the things that you want to tell them is try and drink some water. 

Rich Bennett 43:19
So the one when it comes to water, there's no such thing as too much water. 

Kristen Perry 43:24
But there can be there can be definitely beach by center. There can be too much water. You don't want to over hydrate yourself because then you really are going to throw your levels off. Oh, yeah. So you can really kind of almost it's much water that you could be taking in. 

Rich Bennett 43:41
Interesting, I think, because, I mean, that's in all honesty and I know I'm going to hear Ryan or somebody say something. I mean, that's my favorite drink is water is when I drink, try to drink at least a gallon a day. 

Kristen Perry 43:53
Okay? Oh. 

Rich Bennett 43:55
Yes, it is my food. 

Kristen Perry 43:56
I believe you. Which it's. 

Rich Bennett 43:57
Going to be a challenge cause we're like, you. 

Kristen Perry 43:59
Know, I never hear. 

Rich Bennett 44:01
That beer. 

Kristen Perry 44:01
That's all. 

Rich Bennett 44:02
Okay, so now I'm going to have to try. And crabs, which is warm. Yeah. Oh, yeah. No. Oh, okay. That's really great. Yes. 

Kristen Perry 44:11
Yeah. 

Rich Bennett 44:12
Low in calories. 

Kristen Perry 44:13
Yes. 

Rich Bennett 44:14
But the season is probably not. 

Kristen Perry 44:15
So 

all that year. You think? Yeah. 

Rich Bennett 44:19
Wash it off. Yeah. 

Kristen Perry 44:21
Why not? You don't have to. I'm just saying yes. 

Rich Bennett 44:24
Oh, okay. 

Kristen Perry 44:25
You sure? You okay? 

Rich Bennett 44:27
Well, I ain't eating the show anyways. Yeah. Wow. I know. I miss a lot of stuff. Somebody's got to have some questions because I'm busy. A lot annoying. 

Ronya Nassar 44:40
I was going to say, did you guys mention about, like, evidence based programming? 

Kristen Perry 44:46
No. Jump in just earlier on as far as you know, how long the program has been around. 

Ronya Nassar 44:50
But so I would say, like you asked earlier, what's the connection to like public health and diabetes prevention program that's considered what is called an evidence based program. So when we say evidence based, that means that it's something that has been tested over and over and over again with different populations, and it is shown that it has worked. So in public health, what we do when we put out programs and things like that, we want to put out programs that are evidence based. Back then, research shows that it works, and that's one thing that's the benefit why we're pushing diabetes prevention programs, because we have research to prove that it's work, to prove that it saves people, you know, it gets people to learn that you can see you lose weight, it increases the physical activity. It even if you think about it in like a cost benefit analysis, it can help save money to people, helps these money populations. They're they're getting healthier then they're not going to the hospital and things like that. So I think when we were asking like earlier the connection to public health, that's one thing. You know, we're always going to be pushing that evidence based programming out. And that's like a good thing that we're offering here at the health Department. It's a good thing that the hospital offers it because it's a really good benefit to the community to offer something that we know that works. 

Salma Cavallo 46:02
Hmm. Yeah. And we use the CDC curriculum that's based on them. And the government recognized there's a need so provides these funds for us to do these programs. 

Rich Bennett 46:12
How often do you guys get out in the public and push this or talk about I should say. 

Kristen Perry 46:17
I'm sure you have. 

Salma Cavallo 46:18
Every every out, every community event that I attend, I am pushing for this for these programs. I have flyers. I was just at the the Hartford Farm Fair and our flyers were being provided there, you know, to anybody who's interested. Um, I, I do several community events per month. I'd say maybe at least eight. 

Rich Bennett 46:47
Per each month. 

Salma Cavallo 46:49
Yeah. Wow. Seven maybe. Maybe not as much. Six or seven. Yeah. Yeah. Outreach. And so, yeah, we're just promoting the. 

Ronya Nassar 46:58
Program. 

Kristen Perry 46:59
And it's getting put on all the social media sites, right? Yeah. 

Salma Cavallo 47:03
So and University of Maryland, we're partners with them, so they give us some referrals to. 

Rich Bennett 47:12
What if we did one with some of the people that went through the program later, another record about diabetes, but also. Yeah, Oh yeah. Some people have gone through the program too. 

Kristen Perry 47:23
Many because within our within the first two, the two completed cohorts that I did, I mean the success rate is wonderful. The first 

77% of the people and then the second one I had over 80%. And right now the two I have going on right now, I don't want to give the stats, but I want to say we're probably at least 80% for both of them right now that are on their way to meeting their goals. 

Rich Bennett 47:49
So the ones that don't hit their goals, are they allowed to come back? 

Kristen Perry 47:52
Absolutely. Yeah, they can. And goals being the goals are one of three things or all of them. One is to lose 4 to 7% of your starting weight. 

Rich Bennett 48:03
Okay? 

Kristen Perry 48:04
The second one or lose 4% of your weight and achieve 150 minutes of physical activity each week or reduce your agency by 0.2%. Yeah, sure. 

Rich Bennett 48:17
Not my coach because I just got it. I got a text about all that stuff too. 

Kristen Perry 48:22
Yeah. Yeah. So they're the program goals, right? So they can meet one or all three of those. 

Rich Bennett 48:30
Huh? 

Kristen Perry 48:30
So as far as when I say I had, you know, 77% 80, that means that of that number. So seven of my nine people met either the weight or the agency or even both. 

Rich Bennett 48:42
And where do you guys where do the groups need it? 

Kristen Perry 48:44
So all over throughout the county, my next cohort is actually starting next Wednesday and we're going to be meeting at the Harker Resource Center right down the road on the street. I've also had one and happen to Grace. Okay, that one finished up and then the other two I have going on there virtual. 

Rich Bennett 49:01
How many times a year. 

Kristen Perry 49:04
That they as soon as they have enough to fill a class, they'll start them. So I would say at least one every three months is going on really, because at least I'm doing I'm on my way to starting having three active right now, but I'm not the only coach. There's several other coaches out there. So there's other cohorts going on right now. 

Rich Bennett 49:21
So with the Hispanic community, are you getting a lot of people involved as well? 

Salma Cavallo 49:25
You are, yes. Good response. We made an on EL Sole radio station outside of Baltimore, and that has brought in quite a bit of people really to our program. 

Rich Bennett 49:39
Yes, that's awesome. 

Salma Cavallo 49:42
Yeah. Yeah, I do get my classes filled, mostly the Hispanic ones. A lot of these people do not have vehicles or have two or three jobs. So we, we, ours are mainly virtual. 

Rich Bennett 49:55
Okay. 

Salma Cavallo 49:55
Yeah. With the two in person to check, they're able to see. 

Rich Bennett 49:59
Yeah, that's good because lately it's a lot of programs and their transportation is a problem. Been a problem. 

Kristen Perry 50:07
A lot lately and. 

Rich Bennett 50:10
So for some reason reasons not get it fixed we got to fix that. But that's another. 

Kristen Perry 50:14
That's another, another piece. 

Rich Bennett 50:16
Yeah, that's a whole separate one. Do you ladies have anything to add? Before I get to my last question for you too. 

Kristen Perry 50:25
I'm busy, so. Yeah. 

Rich Bennett 50:27
Well, a minute. So what's the website. 

Sarah Will 50:30
Well Harford County health dot com. 

Rich Bennett 50:34
Told you you're going. 

Kristen Perry 50:34
To end up talking Well you said you. 

Ronya Nassar 50:37
Go to Harvard County Health dot com and then go to our services under population health there's a diabetes prevention tab and you can find any probation period or something and you can take the quiz to figure out your pre-diabetes status. 

Rich Bennett 50:51
You're like, I need to take the questionnaire. Not because you keep giving me that look. 

Kristen Perry 50:55
You take the. 

Ronya Nassar 50:56
Quiz, but I also get to pass. 

Rich Bennett 50:58
Right? Okay. Yeah, but see, I don't want to take away from somebody else, though. 

Ronya Nassar 51:02
You're not. I mean, you're not taking away from somebody else. You're qualified for. 

Kristen Perry 51:07
It, and. 

Ronya Nassar 51:08
You would love it. 

Rich Bennett 51:09
I would love. 

Kristen Perry 51:10
It. Yes. 

Rich Bennett 51:11
Yes. You want to pick on me like some people in the you. 

Ronya Nassar 51:16
I'm looking out for you. I think this is a really good class. I, I, I've always been an advocate of this class. 

Kristen Perry 51:23
Through like. 

Ronya Nassar 51:23
Before. 

Kristen Perry 51:24
I actually I'm trying to think we probably need more men in our class right now. I think. I think I've had four total. 

Ronya Nassar 51:32
Men and all the. 

Kristen Perry 51:33
Other ones have been women. 

Rich Bennett 51:34
So are people admitted to class if they're already diabetic? No. No. 

Kristen Perry 51:39
So just only treating. 

Rich Bennett 51:40
Diabetic. 

Kristen Perry 51:41
Pre diabetes because there's other classes that the hospital offers for diabetics. Although yes. 

Salma Cavallo 51:47
In my classes I do have a couple of diabetes diabetic clients. Okay. Within the classes. 

Kristen Perry 51:55
But again. 

Salma Cavallo 51:55
It's. 

Kristen Perry 51:56
Not they're in there because she's providing the information to us. We just can't use our information. Reports was easy. Exactly. 

Salma Cavallo 52:03
Yeah, but they're still we don't close the door down. 

Kristen Perry 52:05
Anybody, right? Yeah. Okay. In fact, actually, in one of my groups, I did have a a person that had their agency was in the diabetic range, was in our class, and now she still enrolled in the class. It's still going on and her levels are now even below really range. Yeah. Yeah. Yes. Mhm. Yeah. 

Salma Cavallo 52:28
Information is good for anybody. 

Ronya Nassar 52:30
Surprised. I read a little. 

Kristen Perry 52:31
Changes you can make that will affect your, your levels. 

Rich Bennett 52:35
Oh I'm already seeing it. Yeah. 

Kristen Perry 52:37
Which but it's a combination. It can't just be diet. We really push exercise here. 

Rich Bennett 52:42
Yeah. The exercise is, is my biggest problem because I'm 

532. If I cook dinner back downstairs working again until eight oh, I need to get outside and walk or at least find my elliptical. Yeah, I know. It's downstairs. 

Kristen Perry 53:01
Sorry, That's close. How is it hanging dry in your clothes? No, no, no. 

Salma Cavallo 53:08
And that's one of the topics we addressed, too. We just addressed it last night. 

Finding time within your daily routine where you know you can exercise just a few minutes here. They're parking further in. 

Kristen Perry 53:23
And how do you do that? 

Salma Cavallo 53:25
You know, you're taking a basket at the grocery store because you're carrying weight instead of pushing a cart. You know, little things like that is what we actually write. 

Kristen Perry 53:37
Small bits of time, you know, 10 minutes here, 10 minutes or so. 

Rich Bennett 53:41
Even my daughter, the one day care, she goes to the lady that runs the daycare would always get steps in the house. And when she hit 10,000 steps, Grace, I mean. 

Kristen Perry 53:57
It. 

Rich Bennett 53:58
Is maybe hitting 10,000 steps or was she in her house? She would purposely just walk up or down stairs to get the steps in. My problem is I'll do that, but I forget to put my foot. So I don't I forget how many steps I'm taking. 

Ronya Nassar 54:14
You know, get yourself a finish. 

Kristen Perry 54:16
Yeah. 

Rich Bennett 54:16
I got I'm charging my watch. I found it. 

Ronya Nassar 54:18
But that you don't need. That's not that's a big thing for us. Yeah. Right now we think as well as we need to stand. 

Rich Bennett 54:25
We'll hear from you guys. I understand. 

Kristen Perry 54:26
Yes, I know. I see how I'm saying. 

Rich Bennett 54:30
All right. So I want I want to ask you, I love asking this question. Okay. We'll start with you. Okay. How long have you been with the health department and why did you decide to come work in case? 

Salma Cavallo 54:41
That's a very good question, because this has been one of my passions. I have been with the health department two years. I started as a tobacco prevention special tobacco cessation. And and I was brought into this department, and this is when I started diabetes. So I've been doing this for about a year. Diabetes prevention. I've started my third cohort. The reason I did this is because my background, I went into nursing, but I didn't finish. I went to medical school. I teach anatomy physiology. I taught back in the college level and I was a science teacher, my background. So all of this leads to this applied science career that I now have, where I'm actually working with these individuals who want to make a change and to see the changes and the aha moments is the best reward, really. I mean, to to help people at this level is I think, the greatest passion and the greatest rewards that we're seeing. 

Rich Bennett 55:48
So that's why it's something you mentioned tobacco. Doesn't that have an effect on those areas as well? 

Salma Cavallo 55:54
So we address that if it's a problem. 

Kristen Perry 55:56
With drug groups. 

Rich Bennett 55:58
What about I mean, because I know a lot of people are quitting cigarettes, but vaping, does that have an effect on diabetes as well, or is that not known yet? 

Kristen Perry 56:07
I don't think there's there's not that out there yet as far as, you know how. 

Salma Cavallo 56:12
It affects the. 

Kristen Perry 56:13
As well on your health. I would think that actually it's probably even worse. 

Rich Bennett 56:16
Okay. Within this grant. 

Zach Macas 56:18
We actually also do tobacco because tobacco and diabetes go. 

Rich Bennett 56:22
Hand in hand. 

Zach Macas 56:23
Yeah. Some of does the tobacco stuff, too, so. 

Rich Bennett 56:26
Oh, you're still doing it. 

Salma Cavallo 56:27
Yeah. I educate the young ones and anybody that comes to our information tables at our events on the dangers. 

Ronya Nassar 56:35
Of Yeah. 

Rich Bennett 56:38
Yeah. 

Kristen Perry 56:39
Yeah. Your time. Oh, I'm with the health department. December will be 20 years. 20 years? Years? Yeah, 20 years. So. Really? Yeah. Wow. Yeah, Yeah. Well, with I. 

Rich Bennett 56:52
Mean, I know I've been here 20 years, I mean, but, like. So why did you decide to get into public health? 

Kristen Perry 56:59
Oh, gosh. So I loved nutrition and health dietitian. So there's usually three different pathways with being a dietitian, you can go a community health real food service or clinical. And clinical is more you're working in the hospital and seeing people and then you'll never see them again. Give me a little script. Here you go. You know, you just had heart surgery. Here you go. Here's a paper on heart health and food service. Not my thing. Don't want to I don't want to do fitness, but community health is more. Again, you're dealing with your own community. You're seeing them grow and develop and watching them make changes. And I think that to me is the most rewarding. There's more reward out of public health because you can see them. I used to work in the book program and you would see, you know, generations, you see the children come through. So you just see that growth and development. 

Rich Bennett 57:51
All right. So you've been here. You've been here. 

Salma Cavallo 57:54
Just a couple of years. 

Rich Bennett 57:55
Just a couple of years, and you've worked in two different programs so far, right? 

Salma Cavallo 57:58
Yes. 

Rich Bennett 57:59
Yes. How many years have you. 

Kristen Perry 58:00
Worked to just assist with the work program, which is for women and children? And then now it's considered nutrition services? Oh, yeah. So yes, but then just starting with, you know, same thing. I'm going on a little over a year with the diabetes coaching. 

Rich Bennett 58:19
So to wrap it up, tell everybody why it is important that they go ahead and register for this program. 

Kristen Perry 58:27
I think to make that diet and lifestyle change, to really dial in to yourself and take care of yourself first. Because many of us out there and we're taking care of other people, but we don't take care of ourselves first, We're not going to be any good to our loved ones. 

Salma Cavallo 58:42
Yeah. Yeah. And just to add to that, Hispanics out there, if they're out there, it's 100% in Spanish. That is my heart language. And so the help is out there. It's just a matter of taking advantage. And it's really as as Kristen said, it's really something you're doing for yourself. And people should take pride in their health and make the right changes. 

Rich Bennett 59:12
So I love it. Thank you all.