Don’t wait…. act now!



As regular readers of the LifeShape Blog know, I have written numerous posts in the past about diabetes. The reason for this is obvious. Diabetes is a terrible disease. It affects multiple parts of our body. It is the number one cause of renal failure, amputations, and blindness. There are two types of diabetes Type 1 and Type 2. Type 1 is what we use to call Juvenile diabetes. It is marked by a lack of insulin production requiring insulin injection or pancreatic transplant. Type 2 is the more common type. (Previously known as adult onset or non-insulin dependent. Neither description is accurate). Type 2 diabetes is marked by insulin resistance in the tissues. Initially Insulin levels are very high. Over time the cells that are making this large quantity of insulin start to fail leading to the need for insulin therapy in the later stages of type 2 diabetes. Type 2 diabetes is the disease that is most strongly associated with extra weight. Weight reduction is the most powerful therapy for control of type 2 diabetes. Control of diabetes is critically important because poor control accelerates end organ damage in multiple organs (heart, kidneys, eyes, peripheral nerves leading to neuropathy). Once the damage to these organs occurs it is not reversible.

diabetes testing

One of my recurrent observations as I have practiced weight loss surgery over the past 11 years, is that there is larger variability in when patients decide they need to intensify their efforts to lose weight and become healthier. Many seek out weight loss surgery already having profound health issues and have suffered with an unhealthy amount of weight for far too many years. True some of these patients have wanted to proceed, but have been blocked by insurance, financial, or life circumstance. But in general my sense is that often people don’t adequately see the severity of their situation.

The latest research article that we at LifeShape have published is entitled: Control of type 2 diabetes after 1 year of laparoscopic adjustable gastric banding in the “helping evaluate reduction in obesity” (HERO) study. It appears in the journal Diabetes, Obesity, and Metabolism. I am honored to be a coauthor on the study with doctors Edelman, Dixon and others. The study is part of the HERO trial that many of our LifeShape band patients have participated in over the past five years. This most recent article has shown what many other articles have shown:

  • Similar to the APEX study (which also include many LifeShape patients), centers involved in the HERO trial were committed to success of lap-band patients and as such achieved excellent weight loss.
  • Many patients achieve excellent diabetes control after lap-band
  • Lap-Band has a very safe risk profile

I feel the most significant finding of the study is that the longer a patient had diabetes preoperatively, the harder it was to achieve adequate diabetes control. For every additional year of diabetes there was a 9% increase likelihood of not achieving good diabetes control. So “I will do it next year” has very real adverse consequences.

Don’t wait…..act now!

Dr. Fusco


Summer Fitness Tips


It’s that time of year again when the temperature seems to have reached the boiling point every day, and the humidity levels are relentless.  However, this should not stop you from getting outside and achieving those fitness goals.  Here are a few quick tips to help make your Florida summer fitness plans more enjoyable.

Bookend Workouts:

During the summer, the coolest parts of the day are often dawn and dusk.  The dawn hours allow for you to squeeze in a workout before the sun emerges over the horizon and raises the temperature.  Dusk is another great time to enjoy the cooler evening breezes and more comfortable temperatures.  It is important to make sure that wear clothing or accessories (e.g., lights or reflective clothing) that ensure you are visible to those around you, especially drivers.  If you have to work out in the middle of the day, make sure to decrease both the duration and intensity of the workout, while also allowing for increased rest.

Wacky Weather:

Florida weather is unpredictable and can be potentially dangerous.  A little sprinkle can be refreshing on a warm summer day, but torrential downpours present the danger of decreased visibility and slippery footing.  Be sure to always check the weather report before heading out the door to ensure that there are no thunderstorms or severe weather patches nearby.  If you are outside and get caught in an unsafe weather situation, try to find shelter under the awning of a nearby building or other safe structure.  Always avoid being the tallest object in an open area if you see lightning nearby.

Never Seems Like There is Enough Water:

Hydration is essential 12 months a year, but especially critical as our bodies lose excess water when the temperature and humidity are on the rise.  Our bodies lose two-to-three times as much water through sweat during the summer as compared to cooler months.  If you plan on being outside for an extended period of time, it is important to replace both water and lost electrolytes with a specially formulated beverage.  There are number of low-to-no calorie electrolyte drink options that can help you perform at your highest level.

What to Wear?:

Being comfortable and cool is essential when exercising outdoors in the summer.  In this manner, cotton is the enemy.  It is important to wear light-colored, comfortable clothing made of breathable, moisture-wicking, synthetic fabric.  This will allow the sweat to be drawn off your body to ensure that you remain as cool as possible.  There are many different brand and styles of such clothing that come in almost every color and pattern imaginable.  Some new articles of clothing are even infused with Xylitol, the cooling component of many chewing gums, which helps increase comfort levels while working out in the heat.  Finally, the optimum fit of the clothing is ideal to avoiding painful chaffing or unwanted wardrobe malfunctions.

Sometimes the Fitness “Burn” Isn’t Such a Good Thing:

Sunburns are very dangerous and precautions must be taken to avoid them at all times.  Sunscreens are a great first line of defense to prevent the sun’s harmful rays from damaging our skin.  Visors and hats are another perfect option for keeping the sun out of your face.  In order to protect your eyes, polarized sunglasses should be worn whenever outside for extended periods of time.  When choosing clothing for fitness in the summer months, be sure that they provide some level of SPF protection to decrease the risk of skin damage.  Finally, trying to plan your workout to have as much shade as possible will not only help to keep it cooler, but it will also help you to avoid the sun’s harmful rays.

Now it’s time for you to get outside, get sweaty, and have fun.  Just remember to start slow and be safe at all times.

To take your fitness to next level, be sure to stop by 1130 Hickory St. or call (321-725-4500 ext. 7395/7391) the LifeShape Fitness Center and speak with one of the experienced personal trainers with any further questions you may have regarding our exciting Personal Training and Group Fitness opportunities.

Andy Dutra, MS, AFAA-CPT
LifeShape Personal Trainer & Group Fitness Instructor

Starting at the End


Many athletes (both professional and recreational) often overlook the importance of what happens AFTER a great workout –> RECOVERY!!!  Recovery is the secret to seeing the gains and achieving the goals you have set for yourself.

What Exactly is Recovery?:

After a workout is over, and you have wiped the sweat from your eyes, the real benefits of fitness can begin.  During a cardio or resistance training session, we often put our bodies under a great deal of stress.  After this is over, rest and relaxation are just as important as working-out hard.  Proper levels of rest will ensure that body reaches it optimum levels of performance, and avoids hormone imbalances or fitness plateaus.  It is important to stretch and elongate your muscle after likely shortening them during the concentric phase of exercise.  By stretching and resting, this will allow your muscles to heal properly and the body will ultimately get stronger.

On top of stretching and resting, it is important to be sufficiently hydrated before, during, and after all fitness endeavors in order to allow the muscles to heal and flush any toxins or lactic that may build-up while exercising.  The use of ice baths, hot/cold compresses, foam rolling, massage, or compression garments can also be useful tools to aid in the quick and effective recovery of tired muscles.

However, recovery is more than just resting your muscles, stretching or taking an ice bath.  If you’re training hard, but still not seeing the results you’d like, it’s likely due to a lack of proper nutritional support. You deserve to reap the benefits of the time and effort you’ve put into training, but that requires some effort in the kitchen too.  A little extra mindfulness of the key components of recovery nutrition and you’ll be on your way to the results you desire.

Protein Synthesis and Muscle Glycogen Recovery:

What you eat immediately after exercise is critical for muscle recovery, and a ratio of 4 parts carbohydrate to 1 part protein is optimal so you can train again tomorrow.  Carbohydrates help replace what was burned during exercise, thereby speeding recovery.  Protein initiates the muscular repair process and helps the carbohydrates enter the blood stream more quickly.

Soft Tissue Recovery:

Physical activity creates micro tears in muscle, tendons, ligaments, and connective tissue. The correct ratio of protein and carbohydrates helps muscles repair and replenish quickly, becoming stronger than their previous workout level.  However, solely focusing on muscle recovery will increase risk of injury since muscles will recover faster than the often-neglected soft tissue.  Comprised of cartilage, these other soft tissues lack the ability to store carbohydrates or have blood circulation.  Therefore, soft tissue recovery needs are specific and completely different from that of muscles.  Speeding muscular recovery without addressing tendon or ligament recovery will create an imbalance and likely lead to strain and/or connective tissue injury.  Rest and a balanced diet are the best tools to ensure that both your soft tissue and your muscles are ready for a great workout the next day.

Try taking a yoga class (Wednesdays at 6:30pm at the LifeShape Fitness Center) for a chance to allow for both physical and mental recovery.  Be sure to stop by 1130 Hickory St. or call (321-725-4500 ext. 7395/7391) the LifeShape Fitness Center and speak with one of the experienced personal trainers with any further questions you may have regarding recovery or to inquire further about our exciting Personal Training and Group Fitness opportunities.

Andy Dutra, MS, AFAA-CPT
LifeShape Personal Trainer & Group Fitness Instructor

The Magnificent Mango

Mango with section on a white background
According to the National Mango Board, mangos are the most popular fruit in the world, and lucky for us they are plentiful and delicious in Brevard County! While we are at the height of the season, remember you can stock up now and freeze the fruit for use in recipes all year long. Mangos are a great source of fiber, vitamins & minerals (highest in Vitamins A & C and Folate), and they’re a sweet treat that actually comes in many different varieties varying in both taste and texture. For more information on mangos, including fun facts and tips on how to select, ripen and cut them, click here. The Produce for Better Health Foundation also offers the following as 10 ways to enjoy mangos:

  • 1. Mango Salsa: dice & combine mangos, red onions, jalapeños, cilantro and lime juice to serve over fish, shrimp, chicken or pork.
  • 2. Frozen Treat: blend sliced mangos with orange juice or yogurt, then freeze in ice trays or popsicle molds for a cool treat on a hot day.
  • 3. Puree & Drizzle: puree a mango then drizzle over low-fat vanilla ice cream/frozen yogurt and top with a few berries – it’s a healthy alternative to please your sweet tooth.
  • 4. Mango Tea: for a naturally sweet taste and a decorative touch, slice and freeze mangos then add to your favorite iced tea.
  • 5. Pancakes, muffins and/or oatmeal: mix pureed mango into any pancake/muffin batter or add to cooked oatmeal for a refreshing twist.
  • 6. Mango Kebob: add mangos to the skewers to sweeten up your traditional kebobs.
  • 7. Smoothies: blend 1 cup of orange juice, 1⁄2 cup of yogurt and one banana; add 6 ice cubes and 1 diced mango, blend again & enjoy!
  • 8. PB & M: skip the jelly and top your peanut butter with mangos! Toast whole wheat bread, spread with peanut butter and add mango slices for a sweet change to the old standby.
  • 9. Parfait: layer low-fat/Greek yogurt, whole grain granola and/or nuts, raisins and mangos.
  • 10. Quick Dessert or Sweet Side: mix mango, banana, strawberries and oranges in a bowl with chili powder, lime juice and honey; serve chilled.

Kristine Van Workum, RD, CSSD, LDN
LifeShape Registered Dietitian & Owner of Brevard Nutrition


July 2014 Recipe – Arugula, Mango & Avocado Salad
Recipe Link
Vinaigrette Ingredients:
• 1 Tbsp champagne vinegar
• 4 Tbsp orange juice, ~1/2 orange
• 2 Tbsp lime juice, ~1/2 lime
• 4 Tbsp olive oil
• ½ tsp cumin
• 2 Tbsp cilantro, chopped
• 1 red chili pepper, sliced (optional)
• salt & pepper to taste
Salad Ingredients:
• ½ red onion, sliced
• 6 cups arugula leaves
• 1 mango, peeled & cut into long slices
• 1 avocado, peeled and sliced
• 1 Tbsp lime juice
• Combine all the ingredients for the salad dressing in a jar, close it tight and shake until the ingredients are well mixed.
• Soak the onion slices in warm water with a dash of salt and 1 tbs lime juice for about 10 minutes.
• Rinse and drain the onions slices.
• Toss the arugula leaves with half of the vinaigrette.
• Add the avocado slices, mango slices and onion slices to the arugula mix, drizzle the remaining vinaigrette on top. Serve immediately. (* this is great as an entree salad if you top with grilled shrimp or fish!)

June is Dairy Month


Did you know June is National Dairy Month?? Here is some interesting info on dairy foods:

  • 1 cup of milk provides 9 essential nutrients (calcium, Vitamin D, phosphorus, riboflavin, Vitamin B12, protein, potassium & Vitamin A)
  • Several cheeses are low-lactose or lactose free, so if you are lactose-intolerant you may want to experiment with small amounts of cheddar, colby, swiss, parmesan, mozzarella & monterey jack to see what you can tolerate. Also, the live & active cultures in yogurt can actually help aid in the digestion of lactose, so many people who are lactose intolerant can enjoy yogurt in small amounts. Click here for more information on lactose intolerance, or visit the National Dairy Council website.
  • Get creative – you can add milk/cheese in cooking, use Greek yogurt in recipes for dips (plain Greek yogurt can replace sour cream/mayo), and for ideas on health benefits/recipe ideas of milk & oats.
  • Milk can be a great refueling choice for athletes/sports nutrition. For more on this topic, click here.
  • For more recipe ideas and ways to work in dairy foods/calcium sources into your diet, you can also visit the Dairy Council of Florida/Florida Dairy Farmers website.

With the 4th of July around the corner, the recipe below will be a hit at any cookout (and incorporates a dairy food/dipping sauce!):

Kristine Van Workum, RD, CSSD, LDN

LifeShape Registered Dietitian & Owner of Brevard Nutrition (


July 2014 Recipe: Chicken Kebabs with Lemon-Pepper Yogurt Sauce




  • 2 cups extra-virgin olive oil
  • Juice of 3 lemons
  • 2 tablespoons chopped garlic
  • 3/4 tablespoons chopped fresh rosemary leaves (about 4 sprigs)
  • 3/4 tablespoons fresh thyme leaves (about 5 sprigs)
  • 6 single boneless, skinless chicken breasts, cleaned of fat and cut into large cubes
  • Salt and black pepper to taste
  • Bamboo skewers


  • 2 (7-ounce) containers plain yogurt
  • 4 tablespoons sour cream
  • 3 tablespoons red wine vinegar
  • Zest of 2 lemons (fine)
  • Juice of 1 lemon
  • 2 tablespoons minced garlic
  • 1 tablespoon black pepper
  • 2 teaspoons salt
  • 1/2 cup fresh mint, chopped (optional)


  • For the kebabs: in a plastic bag or airtight container, combine olive oil, lemon juice, garlic, rosemary, and thyme. Add chicken, toss well to coat evenly, and refrigerate overnight.
  • For the sauce, combine all ingredients in a mixing bowl and refrigerate at least 2 hours.
  • Remove chicken pieces from marinade and season well with salt and pepper. Grill chicken for 5 minutes on each side, until golden brown and juices of chicken run clear when pricked with the end of the skewer. Thread 3 pieces of chicken onto each skewer. Serve with Lemon-Pepper Yogurt Sauce.

Eat Your Veggies!


I am often asked by parents: “How do I get my kids to eat their veggies?!” As a mother of a 17-month-old, I have been lucky enough (so far) to have a child who eats just about anything, including her veggies. I do realize that even as a dietitian mom, toddlers are unpredictable and this could change at any moment. However, if my daughter does move over to the “picky-eater dark-side,” my hope is that it will be temporary. I would also like to think I can take at least a little credit for my thus far adventurous-eater. Here are several tips for kids (and adults) on ways to increase food variety:

  • Be creative & make trying new foods fun! Research shows if you refer to broccoli as “dinosaur trees” kids are more likely to eat them. I also like to cut fruits & veggies into strips (like a french fry) for a shape that’s easy to hold and appealing to kids.
  • Explore different flavors. We discovered my little one loves tart flavors – we add lemon/lime juice & dill to veggies & she gobbles them up. Sprinkling cinnamon & cardamom in her oatmeal, or mixing in a teaspoon of nut butter after cooking also increases her intake.
  • Make time for family meals. This can be a challenge with our busy lives and varying schedules, but research shows both health and behavior improvements in kids who eat meals with at least part of their family on a regular basis. For more info on how and why to prioritize family meals, visit this previous blog post.
  • Leave your own food biases at the door. Example: I do not like peas, but I made every effort to introduce them in a neutral way and so far my husband and daughter share the love of this tiny green squishy vegetable.
  • Focus on color & variety – we all eat with our eyes to some degree. Try to work in at least 1 new food/recipe per week, and remember it may take trying an item up to 10 times or in various forms before kids figure out if they like it.
  • Pair a new food with ones they already enjoy. My little one likes hummus, so it’s a fun way for her to eat veggies – she loves dipping them in this tasty spread. For more ideas, check out a blog I wrote a couple years ago for Flatout Flatbread on this very topic. For more recipe ideas from my Flatout blogs, click here. We also love the recipe below for a tasty way to eat cauliflower – the whole family likes them!
  • Have your kids participate – they are more likely to be interested in trying something new if they help prepare it, pick out a recipe, or help plant/grow/pick it out in the supermarket. Getting kids involved is a great way to increase exposure to new foods.
  • Disguise it? While I don’t believe you have to “hide” veggies from your kids, mixing pureed pumpkin into baked goods, or stirring diced veggies into sauces can increase intake without the fuss. Experiment with telling your kids what’s in the dish before, during or after they have eaten it and see what they say – you may be surprised! PS. maybe this is why the green smoothie is so popular; adults “sneak” kale/spinach/etc. into their own drinks to subtly incorporate foods with health benefits.

For more kid-friendly healthy eating tips and recipe ideas, visit the Kids Eat Right website.

Kristine Van Workum, RD, CSSD, LDN

LifeShape Registered Dietitian & Owner of Brevard Nutrition (

June 2014 Recipe: Baked Cauli-Tots



  • 3 c (or ~1/2 head) shredded cauliflower (see Note below)
  • 4 oz (or ~1 c) shredded sharp cheddar cheese (2%/reduced fat works well)
  • 1 egg
  • ¼ c cornmeal
  • 1 tsp kosher salt
  • a few grinds black pepper
  • ½ tsp ground mustard


  • Heat grill; Fold four 18-inch long pieces of foil in half, unfold & coat inside with cooking spray
  • Preheat your oven to 400°F. Spray a mini muffin tin with oil or coking spray.
  • Place the shredded cauliflower in a kitchen towel and squeeze out the excess moisture.
  • Combine all of the ingredients in a large bowl, and mix together thoroughly. I like to use a fork.
  • Using a spoon or scoop, divide the mixture between the muffin cups and press down firmly into the cups.
  • Bake at 400°F for 15-20 minutes, or until golden brown.
NOTE: use the shredding blade on a food processor to shred the cauliflower & you can use the stems & florets!