Ingredients

• 1 stick (1/2 cup) trans fat – free margarine
• 4 oz fine-quality dark chocolate, chopped
• 1/2 cup granulated sugar
• 3 egg whites
• 1 Tbsp canola oil
• 1 tsp vanilla extract
• 1/2 cup unsweetened cocoa powder
• 1 Tbsp confectioners sugar, for sprinkling

Preparation

Preheat oven to 375° and lightly coat an 8-inch round baking pan with nonstick cooking spray.

Line bottom with a round of wax paper or parchment paper.

In a microwave-safe bowl, microwave margarine and chocolate on high for 20 seconds, stir, and continue to microwave at 20- second intervals until melted.

Remove from microwave and whisk mixture until smooth.

Whisk granulated sugar into chocolate mixture.

Add egg whites, oil and vanilla and whisk well.

Sift cocoa powder over chocolate mixture and whisk until just combined.

Pour batter into pan and bake in middle of oven for 20 to 25 minutes, or until top has formed a thin
crust.

Cool cake in pan on a rack for 5 minutes.

Turn onto a serving plate.

Dust cake with confectioners sugar.

Nutrition Information

Calories: 162
Fat: 11g
Saturated Fat: 4g
Cholesterol: 1mg
Sodium: 81mg
Carbohydrates: 17g
Fiber: 1g
Protein: 2g

Program Manager, Cooper Diabetes Center

As you prepare for family dinners and get-togethers this holiday season, think about how many people in your family have diabetes. If your mother, father, sister or brother has diabetes, it is more likely you will also get diabetes.

But diabetes can be prevented. There is a window of opportunity right before the diagnosis of diabetes called pre-diabetes. One of the most important studies in the field of diabetes, The Diabetes Prevention Program, has shown us beyond a shadow of a doubt that during this period of time, diabetes can be stopped for many people with pre-diabetes.

How do you know if you have pre-diabetes and what do you have to do to stop diabetes in its tracks?

It is now very easy to check if you are heading toward diabetes.  Ask your doctor for a blood test called a Hemoglobin A1c, which measures the amount of glucose that has “sugar-coated” the hemoglobin in your blood. If you have normal blood glucose, the Hemoglobin A1c is about 5 percent “sugar coated.” If your Hemoglobin A1c is 6.5 percent or higher, you have diabetes. But there is a period of time, called pre-diabetes, when you can turn back the hand of the ticking clock of diabetes, and that is when your Hemoglobin A1c is “sugar-coated” between 5.7 percent and 6.4 percent.

Stopping diabetes is easy. The Diabetes Prevention Program has shown that losing 7 percent of your weight (for a 250 pound person, 7 percent translates into 17 pounds) and exercising 30 minutes a day, five days a week, can stop diabetes in its tracks.  It is a good idea to start with being more active, because being active can help with weight loss. Start with an activity you enjoy and something you know you can do, such as bowling, dancing to your favorite oldies or maybe a walk around the block with a friend.

Then make a family commitment, because if you take care of yourself and are active, there is a good chance your children and grandchildren will follow in your footsteps.

So, this year, as you celebrate the holidays with your family, tell them the steps you will take to lose weight and ward off diabetes – for instance, you’re going to take a walk around your neighborhood, three times a week – so that you will be around to celebrate with them next holiday season, and for many holiday seasons to come.

Remember, you can prevent diabetes by reducing your weight and increasing your activity. Cooper’s comprehensive education and nutrition programs – The Healthy Weigh and The Diabetes Weigh – can help you achieve your goals and ensure your health.

In addition to being Program Manager of the Cooper Diabetes Center, a program of Cooper University Hospital’s Department of Endocrinology and the Center for Health and Wellness, Francine Grabowski is co-author of The Best Diet on Earth, based on The DASH Diet, and Lead Diabetes Educator for the Camden Citywide Diabetes Collaborative.

Choosing healthier foods, being mindful of your portions, and making a few smart substitutions in your holiday menus and recipes can help you stay healthy and still enjoy the season’s feasts and festivities.

Registered dietitian Megan Day, MS, RD, of the Cooper Diabetes Center, offers the following fat- and calorie-reduction tips for some of your holiday favorites:

Party Foods

Choose healthier food options, such as fresh or roasted fruits and vegetables, and grilled or broiled lean meats and fish without the skin. Limit high-fat dressings, including mayonnaise, sour cream, oil and butter; or substitute these high-fat ingredients with the low-fat or non-fat versions. For instance, use skim milk or 1 percent milk instead of whole milk or cream. Try low-fat cottage cheese or plain yogurt in place of cream cheese. When possible, bake or broil appetizers instead of frying; and increase dietary fiber by choosing whole grain breads, peas and beans. Other healthier options to consider are hummus, shrimp cocktail, water crackers, Melba toast, and popcorn seasoned with herbs.

Home-Baked Goods

Use puréed fruits in place of oil for cakes, muffins or cookies. For example, if a cake recipe calls for a half-cup of vegetable oil, use a half-cup of applesauce instead. Prune puree is a good substitute for oil in chocolate cake recipes. These substitutions can significantly cut fats without compromising moisture, texture and flavor. For those watching their cholesterol, two egg whites or one-quarter cup of egg substitute can replace one whole egg.

Turkey Dinner

Considering that the average Thanksgiving dinner contains an estimated 3,000 calories, which is more than most people should eat in an entire day, every little bit counts when it comes to reducing the meal’s total caloric content. Here are some steps that can help you cut calories from your menu without sacrificing taste or tradition:

• Turkey. Eat the white meat rather than the dark meat and don’t eat the skin. White meat has less than half the calories and a quarter of the fat contained in dark meat with skin.
• Stuffing. Use a recipe with raisins or other dried fruit instead of one with sausage or nuts. Substitute some or all of the butter with fat-free chicken broth. Cook the stuffing outside the bird so it doesn’t absorb the turkey’s fat drippings while roasting.
• Mashed potatoes. Replace the fats – cream, butter, sour cream – with the low-fat or non-fat varieties, and season with pepper and herbs.
• Sweet potatoes. Forgo the butter, brown sugar and marshmallows. Instead, mash and flavor the sweet potatoes with orange juice, orange zest and buttermilk.
• Pumpkin pie. Use a low-fat recipe that calls for evaporated skim milk, egg whites and low-fat pie shells in place of the higher-fat ingredients.

Day also offers these helpful hints:

“You can also save calories by drinking non-caloric beverages, such as water, diet soda, or diet or unsweetened iced tea. When you know you’re going to a holiday party, eat a small, healthy snack prior to leaving the house so you don’t over-eat when you get there. Remember, too, to eat slowly. It takes about 20 minutes to feel full, so chew slowly and try to wait 20 minutes before going back for seconds. It’s much easier to eat more the faster you eat. Check out the entire table before deciding which foods you want to eat, and decide which ones are worth the calories. Don’t forget to save room for dessert, but stick with small portions.”

Related Links

• Cooper Endocrinology

Diabetes occurs when specialized cells of the pancreas (a gland behind the stomach) do not produce adequate amounts of the hormone insulin.  Insulin permits the body to process proteins, fat, and sugars in food to make body tissues, produce energy, and store energy.  In people without diabetes, insulin is produced as needed to process food.  But people with diabetes have a reduced supply of insulin or none at all.

One in every 400-600 school-age children has diabetes of one form or the other. Type 1 is most common in Caucasian children (both boys and girls), can occur at any age, with the peak presentation occurring between ages 5-7 and at puberty.  Type 2 diabetes in children has increased 10 fold over the past 10 years.

In Type 1 diabetes, the immune system attacks the insulin-producing beta cells in the pancreas and destroys them.  The pancreas then produces little or no insulin.  A person who has Type 1 diabetes must take insulin daily to live.

With Type 2 diabetes, the body does not respond properly to insulin.  Youngsters who are inactive, overeat, and have a family history of diabetes have the greatest risk of developing Type 2 diabetes. Children in minority groups also have a higher incidence of Type 2 diabetes.

Signs and Symptoms of Diabetes

Most commonly, children can experience frequent urination, excessive thirst and excessive hunger.  There may also be weight loss. The duration of symptoms varies but is often less than a month in Type I diabetes.

Symptoms are often lacking in Type II diabetes and it is frequently diagnosed during routine physicals or screening when a child presents with several risk factors.

Dietary Considerations

Presently, there are no dietary restrictions for people with diabetes.  It is important for everyone to have a healthy diet with a mix of foods, carbs, proteins, fats and fiber.  At one time it was believed that foods containing table sugar were detrimental to the diabetic.  Sweets and treats were forbidden.  Research has shown that all carbs turn into the same sugar – glucose – when broken down in the body.  For instance, the fructose in fruits, the lactose in milk, the sucrose in a Snickers bar, and the more complex starch in a baked potato will all be broken down and converted to glucose once digested.

See today’s Health eCooking recipe for a diabetes-friendly spring salad treat.

The Children’s Regional Hospital at Cooper is fortunate to have two, board-certified, Pediatric Endocrinologists and a Pediatric Diabetes Educator in the Division of Pediatric Endocrinology to assist our patients and their families.  Ernest M. Post, M.D., and Weizhen Xu, M.D., see patients in their offices in Voorhees, Moorestown and Camden.

Upcoming Programs for Children With Diabetes

Join us for two special programs presented by The Children’s Regional Hospital at Cooper just for children with diabetes and their parents.

Pizza & Bowling Party for Children With Diabetes
April 13, 2009 from 11 a.m. – 1 p.m.
Baker Lanes, 761 Cuthbert Road, Cherry Hill, NJ 08002

Does bowling affect diabetes? How about pizza? Join us for a special bowling – pizza party for children with diabetes between 8 and 12 years old.

If you’re between the ages of 8 and 12 years old and have diabetes, join Michelle Laranko, R.N., C.D.E., for a free pizza lunch while we discuss the effects of exercise and pizza on blood sugars, followed by bowling!

Parents or guardians will need to be present for blood sugar testing and to administer lunch insulin only.

Sponsored by Children’s Regional Hospital at Cooper, Division of Pediatric Endocrinology,  Medtronic Minimed, and Lifescan/One Touch Meters.

For more information or to RSVP, call 856-963-3764 by April 9, 2009. Children may register for bumper or regular bowling. Space is limited. Click here for more information.

Discover Diabetes at the Garden State Discovery Museum
May 11, 2009 from 4 p.m. – 6 p.m.
Garden State Discovery Museum
2040 Springdale Road, Cherry Hill, NJ 08003

Join us for a free program, for children with diabetes (ages 2 – 6) and their parents, featuring dinner and a chaperoned hour of fun at the Discovery Museum!

4 p.m. to 4:15 p.m. – Welcome
4:15 p.m. to 5 p.m. – Test, insulin, dinner
5 p.m. to 6 p.m. – Children will enjoy the museum chaperoned by Discovery Museum Staff while parents meet in the auditorium. Dinner will be provided, so bring your own meter and insulin!

Sponsored by Children’s Regional Hospital at Cooper, Division of Pediatric Endocrinology, The Garden State Discovery Museum, & Animas Corporation.

For more information or to RSVP,  contact Michelle Laranko, R.N., C.D.E. at  856-963-3764 by April 27, 2009. Space is limited. Click here for more information.

According to the American Diabetes Association, most of the estimated 16 million American adults who have pre-diabetes will develop type 2 diabetes within 10 years. Research also shows that long-term damage to the body can occur during pre-diabetes, especially to the heart and circulatory system.

“We now know that pre-diabetes – referred to in medicine as impaired fasting glucose or impaired glucose tolerance – is a precursor to type 2 diabetes, a very serious and widespread disease that can result in heart disease, stroke, nerve damage, kidney failure, blindness and limb amputation,” said Denise Joffe, M.D., a Cooper endocrinologist.

“It’s very important for people to recognize and address their pre-diabetes in order to prevent serious complications later on,” added Dr. Joffe.

In a major diabetes-prevention study completed by the National Institutes of Health in 2002, evidence was conclusive that people with pre-diabetes can prevent the development of type 2 diabetes by making modest changes in their diet and increasing their physical activity. They might even be able to return their blood glucose levels to normal, the study suggests.

But recognizing and seeking help for pre-diabetes can be tricky. People with pre-diabetes frequently have no symptoms at all, or they dismiss what symptoms they might have as a normal part of aging.

“Tiredness, darkened skin around the eyes, more frequent urination, increased abdominal fat, changes in vision…these are all possible pre-diabetes signs that many middle-age people simply attribute to the natural aging process,” said Dr. Joffe.

Regardless of symptoms, if you’re overweight and age 45 or above, the American Diabetes Association strongly recommends that you get screened for pre-diabetes during your next routine medical office visit.

Your doctor can utilize two different screening tests to determine whether you have pre-diabetes, the fasting plasma glucose test or the oral glucose tolerance test. Either test is effective in determining whether you have a normal metabolism, pre-diabetes or diabetes. If your blood glucose level is abnormal following the fasting plasma glucose test, you have impaired fasting glucose (IFG); if it’s abnormal following the oral glucose tolerance test, you have impaired glucose tolerance (IGT).

“Screenings for IFG or IGT should also be considered for overweight adults who are under age 45 and have other diabetes-risk factors,” Dr. Joffe said.

Risk factors for diabetes include high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes (development of the disease while pregnant), or belonging to an ethnic group at higher risk for developing diabetes: African American, American Indian, Asian American, Hispanic American/Latino and Pacific Islander.