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Go! Garrett County Well-Being Guide

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Well-BeingG A R R E T T C O U N T Y , M A R Y L A N D W E L L - B E I N G G U I D ELOCAL RESOURCESGoGarrettCouny.com Well-Being App | pg. 4NUTRITIONGrab & Go Healthy Bites w/ Info | pg. 6FITNESSExplore Three Types ofExercise | pg. 11G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E

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STARTTODAYThis guide is designed to provide you with local resources, as you build a supportteam that helps you each step of the way! Making the necessary changes to yourlifestyle is an investment that yields huge benefits! Start today on your journey toliving the healthiest life possible. G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 2Whether it’s a formal diagnosis oftype 2 diabetes, or you take theDiabetes Risk Test (on the nextpage) and realize you may be at ahigher risk for developing diabetesthan you once thought, it’simportant to remember you arenot alone! You have a communityto help support you. There aremany people who have felt exactlylike you, and acknowledging yourrisk is the first step. along with local supports to helpyou take the first steps of yourjourney with confidence.Funding was awarded to thePopulation Health, Innovation, &Informatics Unit of the HealthDepartment by the MarylandDepartment of Health's Center forChronic Disease Prevention andControl to implement strategiesthat align with Maryland'sDiabetes Action Plan. Substantial evidence indicates thatrealistic modifications of diet andlifestyle can prevent mostcoronary artery disease, stroke,diabetes, colon cancer, andsmoking -related cancers.Investments to prevent diseaseand even reverse complications toimprove quality of life hold thepromise of maintaining a vibrant,abundant community. This guideoffers nutrition and fitnessresources Willett WC. Balancing life-style and genomics research for disease prevention. Science. 2002 Apr26;296(5568):695-8.doi:10.1126/science.1071055.PMID:11976443.Supported by the Maryland Department of Health's Center for Chronic Disease Prevention and Control. All programs, policies, activities, and viewsare not necessarily representative of any sponsoring organizations, and reflect individual opinions. Not medical advice, please consult your primarycare provider before starting any new program.

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Lifting others up, sharing resources, andpromoting dedicated people with a variety ofskills, talents, and passions is a mark of anabundant community. On a unique platformfound at gogarrettcounty.com, you’ll findhundreds of resources, helpful tips, and loads ofencouragement to help you improve your healthand experience greater wellbeing all whilepromoting individuals who make GarrettCounty wonderfully abundant!The Population Health, Innovation, &Informatics Unit within the Garrett CountyHealth Department seeks communitychampions and local resources to highlight onthe platform. Participants earn points forwatching and interacting with the content toreceive prizes that encourage healthy lifestyles.If you have a special person, or a uniqueopportunity, that you would like to havehighlighted on gogarrettcounty.com pleaseemail shelley.argabrite@maryland.gov for moreinformation.Produced by the Garrett County Health DepartmentUpdated 5/27/2022Celebrating 1 Year ofCommunityAchievementF E A T U R E DG O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 4

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Not all foods are created equal! We want to encourage you to focus on thequality of your food. One idea is to replace heavily processed foods (that usuallycome in boxes) that are void of nutrient-rich vitamins and minerals with foodsthat are full of them!Nutrition recommendations anddietary guidelines are there to helpus but it’s important we rememberwe have a huge variety of options.Eat foods with high nutritionalvalue so that you’re consuming thebest possible fuel as you managediabetes, or if you just want to eathealthier! It’s important you findthe foods you enjoy andexperiment with combinations thatare easy and taste good to you. The goodnews is thateatinghealthy canbe fun andtastedelicious!E A T C O L O R F U L L Y A N D M A K EV E G E T A B L E S A N D F R U I T Y O U R G O T O ! The color alone indicates thesefoods are healthy, bursting withimportant stuff like phytonutrientsyour body needs to help preventdisease and keep it workingproperly. Out of the hundreds ofvegetables to choose from, thenon-starchy options are the bestlike spinach, carrots, tomatoes, andbroccoli because they are the lowest-carbohydrate, andnutrient-rich options that help youfeel full and satisfied. But by allmeans mix it up, add all kinds offruits and vegetables to your dietthat span the colors of the rainbow.Fresh, frozen, or canned with nosugar or salt is the best choice. https://fdc.nal.usda.gov/FOODG O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 5

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Here’s a list of foods to reach for that are low onthe glycemic index (helping us avoid the dipsand spikes) and that will help us hit our fiberintake target and still keep our carbs in check: Broccoli belongs to the family of cruciferousvegetables, which includes brussels sprouts,cabbage, and cauliflower that give us theincredible crunch we need when we feel likesnacking. Broccoli provides several importantvitamins and minerals, such as vitamin C andpotassium. In addition, it’s a good source offiber. One cup (150 grams) of chopped, cookedbroccoli contains 5 grams of fiber and 6 grams ofnet carbs. Broccoli is especially tasty when it’slightly steamed, sauteed in butter, or roasted inolive oil. When dining out, ask your server toreplace potatoes, rice, or other starch withsteamed broccoli and butter.Green beans are technically consideredlegumes. However, they contain far fewer carbsthan most other legumes, such as beans andlentils. One cup (100 grams) of cooked greenbeans has 3.5 grams of fiber and 3.5 grams ofnet carbs. Try these in the Air Fryer with a littlegarlic! What a treat, although they’retraditionally relegated to the world of the sidedish, double up on your green beans and skip themashed potatoes (or just have one small bite).Grab N' Go!F E A T U R E DMacadamia nuts do double duty by not onlybeing a highly nutritious food that’s low carb butalso one that may help lower LDL cholesterol! Their fiber content is pretty impressive as well.A three-quarter cup (100-gram) serving has justunder 9 grams of fiber and 5 grams of net carbs.Macadamia nuts are a delicious portable snackthat can be enjoyed anytime. Add them to yourfavorite trail mix or eat them as a stand-alonesnack! Blackberries and raspberriesFruit usually isn’t the best choice because mosttypes are high in carbohydrates. Berries are adelicious exception to that and can be enjoyedin small amounts. Raspberries provide 6.5 gramsof fiber and 5 grams of net carbs per two-thirdscup (100-gram) serving, and blackberries followclosely behind with 5 grams of fiber and 5 gramsof net carbs for the same serving size. A fewberries on top of steel-cut oatmeal is amarvelous way to start a day that will be full ofpositive wellbeing choices. Frozen berries are agreat option if fresh aren’t available.https://fdc.nal.usda.gov/G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 6

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Spinach, cooked: 4 grams of fiber and 1gram of net carbs per half cup (100 grams)Kale cooked: 2 grams of fiber and 3 grams ofnet carbs per cup (100 grams)Collard greens cooked: 4 grams of fiber and1.5 grams of net carbs per half cup (100grams)Mustard greens cooked: 2 grams of fiberand 2.5 grams of net carbs per half cup (100grams)Leafy greensSpinach, kale, and other leafy green vegetablesare staples of most healthy eating plans. Inaddition to being rich in nutrients and widelyavailable, they may help you feel full because ofthe fiber they pack! Whether you prefer yourgreens in a smoothie, fresh in a salad, orsteamed, they’re a great choice to avoid thoseblood sugar dips and spikes.AvocadoAlthough it’s a high-fat fruit, it is highly versatilewith a creamy texture and mild flavor. Theyhave more potassium than a banana and canactually be used to make more than guacamole! One-half a large avocado (100 grams) provides7 grams of fiber and 2 grams of net carbs. That’salmost 25% of your fiber intake per day!Avocados are excellent in salads, on sammies, orwith eggs as a smear on toast! Eggs aren’t just for breakfast anymore! At just70 calories and 6 grams of protein, thispowerhouse delivers a big punch of nutrientsincluding B-complex vitamins, vitamin E,calcium, and magnesium just to name a few!Cooking methods and food combinations arealmost endless as well as the convenience andaffordability of eggs. Eating foods like eggs withprotein helps you maintain lean muscle massand that helps your body burn fat. So, hard boil adozen and snack on them all week! A note about Fiber: how much is enough?American adults eat 10 to 15 grams of totalfiber per day, while the USDA’s recommendeddaily amount for adults up to age 50 is 25 gramsfor women and 38 grams for men. Women andmen older than 50 should have 21 and 30 dailygrams. In general, it’s better to get your fiberfrom whole foods than from fiber supplements.When reading a food label, choose foods thatcontain more fiber. As a rule of thumb, choosecereals with 6 or more grams of fiber perserving, bread and crackers with 3 or moregrams per serving, and pasta with 4 or moregrams per serving.https://fdc.nal.usda.gov/G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 7

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Our food needs to taste good, and it’s just too unhealthy to pour salt on our food to add flavor.Often as sodium in our diets increase, blood pressure does too! The American DiabetesAssociation recommends limiting sodium intake to no more than 2,300 mg per day. It can bedifficult to know how much sodium we’re taking in, especially if we’re eating out often or choosingcanned or pre-packaged, processed foods. When possible preparing meals at home can really helpus avoid excess salt, especially when we experiment with spices, herbs, and even juices from citrusfruits!Limit Salt, Instead Spice It UP!M O D E R A T I O NAlways buy reduced or low sodium canned and packaged foods. Drain and rinse canned vegetables and beansUse half of the spice/flavor packets that come in prepackaged convenience meals.A good rule of thumb is to find recipes with fewer than 750 mg of salt per serving. Check the label on the back of all the foods you’re shopping for- the amount ofsodium can be very high even in things you wouldn’t expect- granola bars are agood example! A few tips: https://www.ncbi.nlm.nih.gov/G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 8

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SUGARNaturally occurring sugar found in fruits, veggies, and plain dairy productsshouldn't overly concern you. Our bodies don't process the sugar in these foodsas quickly because they contain digestion-slowing nutrients like fiber andhealthy fats. In other words, the sugar in apples and peppers won't contributeto weight gain and diabetes like a soda or candy bar will. The USDA's most recent dietaryguidelines issued added sugar limits,recommending that we cut out sugarand keep our consumption of thestuff to no more than 10% of overallcalories. To put things intoperspective, the average Americaneats between 73 grams and 77grams of added sugar a day- that'sabout 17 teaspoons of extra sugar!It's hidden in so many foods, so evenif you think you are eating healthy,check the label. Since Jan of 2020the Nutrition Facts Panel nowincludes "added sugar."It's 100% possibleto cut back onsugar, especially ifwe know where tolook!Naturally occurring sugars and addedsugar are lumped together under"sugar." Foods like flavored yogurtcontain both types of sugar. WeMUST read the ingredients list. Thereare 56 different names for addedsugar, common names includesucrose, glucose, fructose, dextrose,maltose—or any word ending in "-ose", high-fructose corn syrup, andfruit juice concentrates. Ingredientsare listed in descending order byweight. So, the closer these sugaringredients are to the beginning ofthe list, the more of that sweetener isused in the food. If several forms of sugar appear on thelabel, think twice about making it a regularaddition to your diet. Sometimes,manufacturers will use several forms ofsugar on the label to prevent a singlesource from appearing close to thebeginning of the ingredient list. In this case,check the nutrition facts panel to see justhow much sugar is in the food. To find outexactly how much added sugar, look at asimilar, unflavored version of the productyou're buying and see the difference. Forexample, if a serving of plain yogurt has 5grams of sugar and a flavored version has25 grams, you'd likely be consuming 20grams of added sugar. When it comes tocandy and sweets, assume all of it's theadded variety.https://health.gov/sites/default/files/2019-10/DGA_Cut-Down-On-Added-Sugars.pdfWard off tooth decay, diabetes, and highblood pressure by cutting back on sugar: G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 9

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When it comes to preparing meals, try to usecooking methods other than frying. If the fatthat you use is solid at room temperature likebutter or lard, try to cut back by using a smallamount of butter and a little olive oil or justeliminate them altogether. Oils like olive,canola, and soybean are liquid at roomtemperature and are better choices becausethey contain less saturated fat. This simplechange may help the cells in your body useblood glucose more effectively, reducingblood sugar. Eating healthier fats improvesinsulin sensitivity, improves cholesterollevels, and may even reduce inflammation.These improvements can also lower your riskfor heart disease! If you are missing the “crunch” fromprocessed foods like potato chips, eating nutsand seeds is a popular healthy alternativethat dosen’t sacrifice convenience. Althoughthey are high in fat, they are low incarbohydrates, and a fabulous source ofvitamin E, magnesium, and selenium. FATShttps://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdfG O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 0

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LIVEWELLWhat does it mean to be fit?There is no easy answer to thatquestion because it's different foreveryone. In our twenties "fit"looks and feels differently than itdoes in our fifties. With eachpassing decade, joint health andflexibility demand more attention. M O V E M E N TAccording to the Department ofHealth and Human Services, theability to carry out daily tasks withvigor and alertness, without unduefatigue, and with ample energy toenjoy leisure-time pursuits andmeet unforeseen emergencies aredefined as physical activity. Park, R.J. 1989. Measurement of Physical Fitness: A Historical Perspective. Office of Disease Prevention and HealthPromotion Monograph Series, Department of Health and Human Services, Washington, D.C.,pp.1-35. NationalAcademies of Sciences, Engineering, and Medicine. 2005. Does the Built Environment Influence Physical Activity?:Examining the Evidence--Special Report 282. Washington, DC: The National Academies Press.https://doi.org/10.17226/11203G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 1

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Improves cardiovascular conditioning.Decreases risk of heart disease.Lowers blood pressure.Increases HDL or "good" cholesterol.Helps to better control blood sugar.Assists in weight management and/or weight loss.Improves lung function.Decreases resting heart rate. Aerobic exercise is physical activity that increases the heart rate and the body's use of oxygen. TheCleveland Clinic describes it this way, "Aerobic exercise provides cardiovascular conditioning. The termaerobic actually means 'with oxygen,' which means that breathing controls the amount of oxygen that canmake it to the muscles to help them burn fuel and move.Benefits of aerobic exerciseIt is appropriate to do aerobic exercise every day. There is no need to rest in between sessions unless youare at an extreme level of training, such as preparing for a marathon, or if you experience reoccurring jointpain. If joint pain is a limiting factor, it would be appropriate to alternate less painful exercises with thosethat may cause joint pain or discontinue the painful exercise altogether."The American Heart Association recommends that everyone reach a minimum of 30 minutes of someform of cardiovascular exercise 5 to 7 days per week. This can be broken up into 10-minute time periods.This means that taking 3 walks of 10 minutes each would let you reach the recommended minimumguideline for reducing the risk of heart disease, diabetes, hypertension, and high cholesterol. You wouldalso burn the same number of calories as you would if you walked for the full 30 minutes at 1 time.The American College of Sports Medicine recommends a minimum of 3 sessions of 30 minutes of the totalshould be made up of moderate to vigorous exercise to improve cardio-respiratory fitness and helpmanage weight.*https://www.heart.org/ **https://www.cdc.gov/***https://www.acsm.org/AEROBICG O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 2

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Heart rate and exerciseYour heart rate increases in direct correlationwith the intensity of the exercise. Heart ratelevels can vary significantly from one personto another based on fitness level, genetics,environment, and exercise tolerance. If youwish to train based on heart rate, contact yourhealthcare provider to determine theappropriate range for you. Some medications,most often blood pressure drugs, controlheart rate, making it difficult to determine. Monitoring intensity in other waysHow can you know if you are working at theright intensity? Using an RPE (Rate ofPerceived Exertion) chart can help you todetermine the appropriate intensity. The scaleuses a 1 to 10 rating system. One is very light,such as walking to the refrigerator for a glassof milk. Ten would be a very significant level,representing maximal exercise. Ten would beindicative of not being able to take anotherstep without fear of collapse. It is notrecommended for anyone to work at a rate of10 without strict supervision by a healthcareprovider. Moderate intensity is the level ofexercise that is most represented by a ratingbetween a 3 and a 5..Intensityhttps://www.cdc.gov/G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 3

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HEARTRATEHow do you know if you're reaching a moderate or vigorous activity zone? One wayof checking physical activity intensity is to determine whether your pulse or heartrate is within the target zone during physical activity.According to the CDC, to figure outwhether you are exercising within thetarget heart rate zone, you must brieflystop exercising to take your pulse. Youcan take your pulse at your neck, wrist, orchest. We recommend the wrist. You canfeel the radial pulse on the artery of thewrist in line with the thumb. Place the tipsof the index and middle fingers over theartery and press lightly. Do not use thethumb. Take a full 60-second count of theheartbeats, or take for 30 seconds andmultiply by 2. Start the count on a beat,which is counted as “zero.” For example, ifthis number falls between 109 and 129bpm in the case of a 50-year-old person,he or she is active within the target rangefor moderate-intensity activity.77% level: 185 x 0.77 = 142 bpm, and93% level: 185 x 0.93 = 172 bpmDeborah Riebe, Jonathan K Ehrman, Gary Liguori, Meir Magal. Chapter 6 General Principles of ExercisePrescription. In: ACSM’s Guidelines for Exercise Testing and Prescription. 10th Ed. Wolters Kluwer/LippincottWilliams & Wilkins, Philadelphia, PA: 2018, 143-179.Physical Activity Guidelines Advisory Committeepdf iconexternal icon [PDF-4.6MB]. Physical Activity GuidelinesAdvisory Committee Report, 2008. Washington, DC: U.S. Dept of Health and Human Services; 2008.For vigorous-intensity physical activity, your target heart rate should bebetween 77% and 93% of your maximum heart rate. To figure out thisrange, follow the same formula used above, except change “64 and 76%”to “77 and 93%”. For example, for a 35-year-old person, the estimatedmaximum age-related heart rate would be calculated as 220 – 35 years =185 beats per minute (bpm). The 77% and 93% levels would be:This shows that vigorous-intensity physical activity for a 35-year-oldperson will require that the heart rate remains between 142 and 172 bpmduring physical activity. If all the calculations aren't for you, most fitnesstrackers can also do the math for you.1.2. 64% level: 170 x 0.64 = 109 bpm, and76% level: 170 x 0.76 = 129 bpmYour target heart rate should be between64% and 76% of your maximum heart ratefor moderate-intensity physical activity. Youcan estimate your maximum heart rate basedon your age. To estimate your maximum age-related heart rate, subtract your age from220. For example, for a 50-year-old person,the estimated maximum age-related heartrate would be calculated as 220 – 50 years =170 beats per minute (bpm). The 64% and76% levels would be: G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 4

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Body weight. You can do many exercises with little or no equipment. Try pushups, pullups, planks,lunges, and squats.Resistance tubing. Resistance tubing is inexpensive, lightweight tubing that provides resistance whenstretched. You can choose from many types of resistance tubes in nearly any sporting goods store oronline.Free weights. Barbells and dumbbells are classic strength training tools. If you don't have weights athome, you can use soup cans. Other options can include using medicine balls or kettle bells.Weight machines. Most fitness centers offer various resistance machines. You can invest in weightmachines for use at home, too.Cable suspension training. Cable suspension training is another option to try. In cable suspensiontraining, you suspend part of your body — such as your legs — while doing body weight training such aspushups or planks.Do strength training exercises for all major muscle groups at least two times a week. Aim to do a singleset of each exercise, using a weight or resistance level heavy enough to tire your muscles after about12 to 15 repetitions.If you have a chronic condition, or if you're older than age 40 and you haven't been active recently,check with your doctor before beginning a strength training or aerobic fitness program.Before beginning strength training, consider warming up with brisk walking or another aerobicactivity for five or 10 minutes. Cold muscles are more prone to injury than warm muscles.To give your muscles time to recover, rest one full day between exercising each specific muscle group.The next type of exercise to build into our daily routine is strength training. The goal is to prevent diseaseand maintain a good quality of life. As we age our body naturally loses lean muscle mass, but we can slowthat process down by focusing on weight-bearing exercise. Strength training is any exercise involving your own body weight or equipment to build muscle mass,endurance, and strength. Strength training can be done at home or in the gym. Common choicespresented by The Mayo Clinic include:For most healthy adults, the Department of Health and Human Services recommends these exerciseguidelines:It's important to use proper techniques in strength training to avoid injuries. If you're new to strengthtraining, work with a trainer or other fitness specialist to learn the correct form and technique. Rememberto breathe as you strength train.https://www.cdc.gov/healthyweight/index.htmlSTRENGTHG O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 5

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GO!YOGALimiting your physical activity orsitting for long periods of time cancause your muscles to becomelimited in their flexibility andrange. And as you age, yourmuscles gradually become shorterand begin to lose some elasticity.Aging can also decrease the rangeof motion in your hips, shouldersand spine. Go! Garrett County hasHUNDREDS of articles and videoson a variety of topics, yogaincluded!https://www.hopkinsmedicine.org/health/wellness-and-prevention/9-benefits-of-yogaF L E X I B I L I T YTo keep your body limber and yourmuscles in good shape, you need tostay active and do exercises thatare focused on flexibility. Yogareduces stress and allows you tofocus by using breath control,simple meditation and bodilypostures. Not only does it enhanceyour balance and flexibility, butyoga also leaves you feelingstronger and more mentallyfocused. G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 6

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FLEX-IBILTYThere is a difference between flexibility and stretching.Flexibility refers to the range of motion for a given joint. The degree of flexibilitythat a person has is influenced by muscles and connective tissues, like ligamentsand tendons. Stretching is a form of exercise that can lead to an increase inflexibility. Taking a class from a licensed professional is a wonderful way to beginthe journey of increasing flexibility through guided instruction. The optimal amount of flexibilityis different for everyone.Unless a joint is hurt, limited rangeof motion may be due to tight orstiff muscles. Dynamic movementlike walking is a great way towarm up your muscles before youexercise. It's a low-intensity,activity that will gradually raiseyour heart rate and increase bloodflow to the muscles. It will alsoslowly warm up your body'stemperature, so you may evenbreak a little sweat. After yourbody is warm and you take yourbrisk walk, jog, or do yourresistance training, slow down.People witharthritis,who needregularphysicalactivity tokeep jointsflexible,maintainmuscle tone,and manageweight, mayfind yogaverybeneficial. Perform static stretching at theright time.Static stretching involves slowlystretching a muscle to its endposition and holding it for a shortperiod of time, usually 10-30seconds. This is the most commonform of stretching and isrecommended at the end of yourexercise routine. Never staticallystretch a cold muscle. Cold musclesare more likely to tear whenstretched improperly. Followresearch-supportedrecommendations or seek helpfrom a qualified professional. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273886/G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 7

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AIMFOR ITKnowing your numbers and thetarget numbers to aim for will helpyou manage your diabetes in boththe short and long term. It’simportant to talk to yourhealthcare team about what theE X C L U S I V Eright targets are for you. TheAmerican Diabetes Associationgenerally suggests the following tohelp manage diabetes and lower therisk of heart disease.<7% for nonpregnantadults with diabetesA measure of average glucoselevels over the past fewmonths. Target:LDL (bad) cholesterol<100 mg/dlHDL (good) cholesterolWomen >50 mg/dlMen >40 mg/dlA waxy, fatlike substance in allbody cells. Targets:Fasting80-100 mg/dlBefore a meal80-130 mg/dl1-2 hours after a meal<180 mg/dlAmount of glucose (sugar) inthe blood. Target Ranges: BLOODGLUCOSEA1C CHOLESTROLBLOODPRESSURE<140/90 mmHGForce of the blood flow in yourblood vessels.Target:TRIGLYCERIDES<150 mmHGA type of fat that circulates inthe blood.Target:https://www.ccjm.org/content/87/4/231G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 8

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There are three types of carbohydrates; fiber, starches, and sugars! Our bodies use them and digest them differently. Fiber is the best type of carbohydrate to eat because it doesn’t raise your blood glucose helping you to avoid the dipsand spikes. It can also slow the absorption of other types of carbohydrates like starches and sugars. There’s something else to consider when we think about the foods we eat and how our bodies use that food. It’s calledthe GLYCEMIC INDEX. According to the Academy of Nutrition and Dietetics, the glycemic index is a measure of howquickly a food causes our blood sugar levels to rise. The measure ranks food on a scale of zero to 100. Foods with ahigh glycemic index, or GI, are quickly digested and absorbed, causing a rapid rise in blood glucose (sugar). The foodsthat will help you the most to manage your diabetes are the ones that will have little or no effect on your bloodglucose (sugar). These are the foods that are mostly or entirely protein and fat. Most experts agree wild pacificsalmon is the best of the best, followed by Gruyere (a type of cheese with virtually no carbs or lactose), eggs, andnuts! Review our Grab & Go section for more snack ideas to keep you steady!UNDERSTANDING CARBOHYDRATES TO AVOID DIPS AND SPIKEShttps://www.eatright.org/G O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E - 1 9

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On-line ResourceG O G A R R E T T C O U N T Y . C O MNUTRITION/RECIPESFood Vouchers and Shop N'Save Gift Cards are Availablein the Prize ShopFITNESS Opportunities to Earn FREEFitness Classes and PersonalTraining SessionsEARN FREE PRIZESRegister for a FREE Accountto Start Earning These and Other Prizes TodayG O G A R R E T T C O U N T Y . C O M W E L L - B E I N G G U I D E

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Individual Needs Group Support Try it FREE Neil Linda and Patsy met their goals So can you Current Cost 49 tax per Yearly Membership Affordable Day Date Wednesdays Doctor recommended Time Lose 10 100 lb Location Garrett County Health Dept Contact 4 00 pm Amy Ritchie 301 334 7730 www tops org 800 932 8677 PI 095 3 18 2018 by TOPS Club Inc

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At Garrett Regional Medical Center National Diabetes Prevention Program Learn healthy eating and lifestyle tips Programs covered by most insurances Garrett Regional Medical Center provides diabetes and nutrition services to empower our patients with the information they need to better manage their health Our Diabetes Education Program helps individuals better manage diabetes or pre diabetes by making healthy choices and lifestyle changes Services include Type 1 diabetes education Type 2 diabetes education Gestational diabetes education Prevent Type 2 diabetes prevention program Insulin pump support Continuous glucose monitor support If you have pre diabetes or risk factors for type 2 diabetes it is time to take charge of your health Learn more about Diabetes Education at GRMC at 301 533 4271

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The Type 2 Prevention Program at Garrett Regional Medical Center is designed to help individuals Build skills to lose weight be more physically active and manage stress Build motivation and accountability Develop habits that last Registration for the Prevent Type 2 Program begins this fall To pre register or for additional information contact 301 533 4271 The Outpatient Diabetes Education Program at Garrett Regional Medical Center provides comprehensive education for Type 1 diabetes Type 2 diabetes and Gestational diabetes The program is instructed by a certified diabetes care and education specialist who works with your physician to develop a plan to keep your blood sugar under control Classes are offered and cover a variety of topics including risk factors preventing complications monitoring healthy eating habits and medications For additional information contact 301 533 4010 Meet with a registered dietitian nutritionist RDN to Review your current eating habits Set realistic and achievable goals Discover your personalized nutrition plan Ask your doctor to refer you for outpatient nutrition counseling Medicare and most insurance policies cover nutrition counseling for diabetes

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DIABETES PREVENTION PROGRAM The Diabetes Prevention Program DPP is for individuals over the age of 18 who have prediabetes or are at risk for type 2 diabetes but who DO NOT already have diabetes Participants will work with a trained lifestyle coach to learn the skills needed to make lasting changes such as Eating healthier Losing weight Reducing stress Increasing physical activity The program is available in person virtual online and a combination to fit your schedule PHASE I LIFESTYLE CHANGES First 6 months Weekly Meetings PHASE II MAINTENANCE Second 6 months Monthly Meetings To register visit UPMCWesternMaryland com DPP or call UPMC Western Maryland Community Health at 240 964 8424

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DIABETES SELF MANAGEMENT PROGRAM If you ve been diagnosed with type 1 or type 2 diabetes LIVING WELL WITH DIABETES is a diabetes self management program with interactive group education Participants will work with a group of health care professionals including Certified Diabetes Educators Nurses Registered Dietitians Pharmacists Wellness Coaches Activity Instructors The program is offered monthly and covers the many aspects of diabetes self management and glycemic control A family member or support person is welcome to attend with you A physician referral is required to attend For more information visit UPMCWesternMaryland com DSMT or call UPMC Western Maryland Center for Clinical Resources at 240 964 8787

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