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November is American Diabetes month. Do you know if you are Pre-diabetic?


What You Need to Know

  • What is pre-diabetes?
  • How do I know if I have pre-diabetes?
  • Who should be tested for pre-diabetes?
  • What can I do about pre-diabetes?
  • Where can I get more information about diabetes?
  • Did you know if you are 45 years old or older, overweight, and inactive, you may have pre-diabetes?

What is pre-diabetes?

Pre-diabetes means you have blood glucose levels that are higher than normal but not high enough to be called diabetes. Glucose is a form of sugar your body uses for energy. Too much glucose in your blood can damage your body over time. Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT).

If you have pre-diabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. Being overweight and physically inactive contributes to pre-diabetes. You can sometimes reverse pre-diabetes with weight loss that comes from healthy eating and physical activity.

How do I know if I have pre-diabetes?

Most people with pre-diabetes don’t have any symptoms. Your doctor can test your blood to find out if your blood glucose levels are higher than normal.

Who should be tested for pre-diabetes?

If you are 45 years old or older, your doctor may recommend that you be tested for pre-diabetes, especially if you are overweight. Being overweight means your body mass index (BMI) is over 25. BMI is a measure of your weight relative to your height. If you’re not sure, ask your doctor if you are overweight.

Even if you are younger than 45, consider getting tested if you are overweight and

are physically active less than three times a week

have a parent, brother, or sister with diabetes

have high blood pressure

have abnormal levels of HDL cholesterol or triglycerides, two types of blood fats

had gestational diabetes—diabetes during pregnancy—or gave birth to a baby weighing more than 9 pounds

are African American, American Indian, Hispanic/Latino, Asian American, or Pacific Islander

have polycystic ovary syndrome

have dark, thick, velvety skin around your neck or in your armpits

have blood vessel problems affecting your heart, brain, or legs

If the results are normal, you should be retested in 3 years. If you have pre-diabetes, you should be tested for type 2 diabetes every year or two.

What can I do about pre-diabetes?

Losing weight—at least 5 to 10 percent of your starting weight—can prevent or delay diabetes or even reverse pre-diabetes. That’s 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting down on the amount of calories and fat you consume and being physically active at least 30 minutes a day. Physical activity also helps make your body’s insulin work better.

Ask your doctor if you should also take medicine to help control the amount of glucose in your blood.

The National Diabetes Education Program’s “Small Steps. Big Rewards. Prevent type 2 Diabetes” campaign has more information about preventing diabetes.

Small Steps. Big Rewards. Prevent type 2 Diabetes. Campaign

Campaign Overview:

Millions of Americans are at high risk for diabetes, a serious and costly disease that has reached epidemic proportions in the past 10 years. The good news: type 2 diabetes can be prevented or delayed. To get this important information to those at risk, the National Diabetes Education Program (NDEP) has created the Small Steps. Big Rewards. Prevent type 2 Diabetes campaign.

The NDEP has created campaign messages and materials for people at risk for diabetes, including those at high risk: African Americans, Hispanic and Latino Americans, Native Americans and Alaska Natives, Asian Americans and Pacific Islanders, women with a history of gestational diabetes and older adults. In addition, the NDEP and its partners are promoting diabetes prevention to health care professionals to give them the information and tools to help their patients take small steps to prevent or delay the disease.

The Science Behind the Campaign

The Diabetes Prevention Program (DPP), a landmark study sponsored by the National Institutes of Health, found that people at increased risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight through increased physical activity and a reduced fat and lower calorie diet.

In the DPP, modest weight loss proved effective in preventing or delaying type 2 diabetes in all groups at high risk for the disease. To this end the Department of Health and Human Services’ NDEP is mobilizing its partners at the national, state, and local levels to promote the DPP’s findings.

The Campaign’s Message

Small Steps: If you have pre-diabetes (higher than normal blood glucose levels but not yet diabetes), losing a modest amount of weight – for example, 10 to 15 pounds for a 200-pound person – can help you prevent or delay type 2 diabetes. You can do it by building up to 30 minutes of physical activity a day 5 days a week and following a low-calorie, low-fat eating plan.

Big Rewards: Preventing type 2 diabetes can mean a healthier and longer life without serious complications from the disease such as heart disease, stroke, blindness, kidney failure, and amputations.

This topic is a big topic but, I hope this answers enough of your questions about pre-diabetes. If you need more help to put your Health and Exercise Prescription together please contact me.

Thank you for your time and enerergy…Be well

Jaime Hernandez

Health and Exercise Prescriptions Inc.



Health and exercise prescription's Blog


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Why does my old back and neck injury keep coming back?

I have seen hundreds of patient at the clinic I used to work at (Bellingham Back and Neck Clinic) and hundreds of people in my business(Health and Exercise Prescriptions) that have been stuck in a cycle of re-injuring them self’s. The processes of recovering from an injury is sometimes long and uncomfortable.

What happens to your back and neck when it becomes injured?

A back and neck injury should be treated with special care because often times your spinal cord and nerves feeding out of your spine get injured or pressed by swelling. When your nerves gets damaged from the injury; that specific nerve does not communicate as well to the corresponding organs and muscles that the nerve controls.

Any time a nerve gets pinched or damaged by an injury it will not functioning properly indefinitely until it is re-trained properly. A good example is some one who hurts their back and favors the side that does not have pain. Even when you are not in pain your body still remembers that pain you had previously and tries to avoid movements that would put it in a place that it does not feel strong.

Most people do not recover from their old injuries all the way for that reason. People want to do regular exercises to help their injury but, most times that makes their injury worse and not better. If you are exercising in pain than you are not doing you body any good. Pain is signal that you body is being injured. ( Remember pain has a lot of different signals that mean different things so if you are not familiar with muscle fatigue than you may report that as pain)

Pain can be:

Numbness, tingling, shooting pain, burning, stabbing, sharp,dull, achy,…each of these pain signals are specific to a certain pathology of your injury or pre-injury .

If you experience pain outside of fatigue when you are exercising  than you are doing too much and or you have a previous injury that still needs special care; if so come and visit us at

Previous injuries, special condition or a disease processes have contraindicated of certain movements and exercises which have to be addressed when designing an exercise program. I can see why some people give up and get frustrated at the notion of  being able to get back into pre-injury conditioning. If you do not do the right exercise then you will keep re-injuring  your self.

Our body’s are so complicated that it often times takes many weeks of stretching and strength to become more than just functional. If you are looking to restore your body back to pre-injury condition than it may take longer than a couple months. I wrote a blog on this topic specific check it out

What does this mean for you?

  • If it hurts don’t do it!
  • If you do have previous injury or pain make sure to take special care to get a program designed for your needs
  • If you are on medications always ask your doctor if there are any supplements or types of exercise you should not do
  • If you have high blood pressure,  diabetes, osteoarthritis, obesity, cancer, or any other disease that you get clearance from your doctor and professional guidance so that you do not hurt your self
  • Start slow with your new exercise
  • remember that recovery from an injury or disease can be a long road

Well I hope that this information is a good start to help with an injury or disease.

If you have any questions please contact me at

Thank you for your time and energy….Be well

Jaime Hernandez

Health and Exercise Prescriptions Inc.


Health and exercise prescription's Blog

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October is celiac disease Awareness month? Is your digestive track healthy?

What is celiac disease?

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins, and lip balms. Drawing of the digestive system with the small intestine highlighted and the stomach, liver, small intestine, and colon labeled. The small intestine is shaded above. When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi—the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats. Drawing of a section of the small intestine with detail of villi. The small intestine and villi are labeled. Villi on the lining of the small intestine help absorb nutrients. Celiac disease is both a disease of malabsorption—meaning nutrients are not absorbed properly—and an abnormal immune reaction to gluten. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy. Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered—or becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress. 

What are the symptoms of celiac disease?

Symptoms of celiac disease vary from person to person. Symptoms may occur in the digestive system or in other parts of the body. Digestive symptoms are more common in infants and young children and may include

  • abdominal bloating and pain
  • chronic diarrhea
  • vomiting
  • constipation
  • pale, foul-smelling, or fatty stool
  • weight loss

Irritability is another common symptom in children. Malabsorption of nutrients during the years when nutrition is critical to a child’s normal growth and development can result in other problems such as failure to thrive in infants, delayed growth and short stature, delayed puberty, and dental enamel defects of the permanent teeth. Adults are less likely to have digestive symptoms and may instead have one or more of the following:

  • unexplained iron-deficiency anemia
  • fatigue
  • bone or joint pain
  • arthritis
  • bone loss or osteoporosis
  • depression or anxiety
  • tingling numbness in the hands and feet
  • seizures
  • missed menstrual periods
  • infertility or recurrent miscarriage
  • canker sores inside the mouth
  • an itchy skin rash called dermatitis herpetiformis

People with celiac disease may have no symptoms but can still develop complications of the disease over time. Long-term complications include malnutrition—which can lead to anemia, osteoporosis, and miscarriage, among other problems—liver diseases, and cancers of the intestine.  

Why are celiac disease symptoms so varied?

Researchers are studying the reasons celiac disease affects people differently. The length of time a person was breastfed, the age a person started eating gluten-containing foods, and the amount of gluten-containing foods one eats are three factors thought to play a role in when and how celiac disease appears. Some studies have shown, for example, that the longer a person was breastfed, the later the symptoms of celiac disease appear. Symptoms also vary depending on a person’s age and the degree of damage to the small intestine. Many adults have the disease for a decade or more before they are diagnosed. The longer a person goes undiagnosed and untreated, the greater the chance of developing long-term complications.  

What other health problems do people with celiac disease have?

People with celiac disease tend to have other diseases in which the immune system attacks the body’s healthy cells and tissues. The connection between celiac disease and these diseases may be genetic. They include

  • type 1 diabetes
  • autoimmune thyroid disease
  • autoimmune liver disease
  • rheumatoid arthritis
  • Addison’s disease, a condition in which the glands that produce critical hormones are damaged
  • Sjögren’s syndrome, a condition in which the glands that produce tears and saliva are destroyed

How common is celiac disease?

Celiac disease affects people in all parts of the world. Originally thought to be a rare childhood syndrome, celiac disease is now known to be a common genetic disorder. More than 2 million people in the United States have the disease, or about 1 in 133 people.1 Among people who have a first-degree relative—a parent, sibling, or child—diagnosed with celiac disease, as many as 1 in 22 people may have the disease.2 Celiac disease is also more common among people with other genetic disorders including Down syndrome and Turner syndrome, a condition that affects girls’ development.

1Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States. Archives of Internal Medicine. 2003;163(3):268–292.


How is celiac disease diagnosed?

Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases. Celiac disease can be confused with irritable bowel syndrome, iron-deficiency anemia caused by menstrual blood loss, inflammatory bowel disease, diverticulitis, intestinal infections, and chronic fatigue syndrome. As a result, celiac disease has long been underdiagnosed or misdiagnosed. As doctors become more aware of the many varied symptoms of the disease and reliable blood tests become more available, diagnosis rates are increasing.

Blood Tests

People with celiac disease have higher than normal levels of certain autoantibodies—proteins that react against the body’s own cells or tissues—in their blood. To diagnose celiac disease, doctors will test blood for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). If test results are negative but celiac disease is still suspected, additional blood tests may be needed. Before being tested, one should continue to eat a diet that includes foods with gluten, such as breads and pastas. If a person stops eating foods with gluten before being tested, the results may be negative for celiac disease even if the disease is present.

Intestinal Biopsy

If blood tests and symptoms suggest celiac disease, a biopsy of the small intestine is performed to confirm the diagnosis. During the biopsy, the doctor removes tiny pieces of tissue from the small intestine to check for damage to the villi. To obtain the tissue sample, the doctor eases a long, thin tube called an endoscope through the patient’s mouth and stomach into the small intestine. The doctor then takes the samples using instruments passed through the endoscope.

Dermatitis Herpetiformis

Dermatitis herpetiformis (DH) is an intensely itchy, blistering skin rash that affects 15 to 25 percent of people with celiac disease.3 The rash usually occurs on the elbows, knees, and buttocks. Most people with DH have no digestive symptoms of celiac disease. DH is diagnosed through blood tests and a skin biopsy. If the antibody tests are positive and the skin biopsy has the typical findings of DH, patients do not need to have an intestinal biopsy. Both the skin disease and the intestinal disease respond to a gluten-free diet and recur if gluten is added back into the diet. The rash symptoms can be controlled with antibiotics such as dapsone. Because dapsone does not treat the intestinal condition, people with DH must maintain a gluten-free diet.


Screening for celiac disease means testing for the presence of autoantibodies in the blood in people without symptoms. Americans are not routinely screened for celiac disease. However, because celiac disease is hereditary, family members of a person with the disease may wish to be tested. Four to 12 percent of an affected person’s first-degree relatives will also have the disease.4

3Rodrigo L. Celiac disease. World Journal of Gastroenterology. 2006;12(41):6585–6593.


How is celiac disease treated?

The only treatment for celiac disease is a gluten-free diet. Doctors may ask a newly diagnosed person to work with a dietitian on a gluten-free diet plan. A dietitian is a health care professional who specializes in food and nutrition. Someone with celiac disease can learn from a dietitian how to read ingredient lists and identify foods that contain gluten in order to make informed decisions at the grocery store and when eating out. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvement begins within days of starting the diet. The small intestine usually heals in 3 to 6 months in children but may take several years in adults. A healed intestine means a person now has villi that can absorb nutrients from food into the bloodstream. To stay well, people with celiac disease must avoid gluten for the rest of their lives. Eating even a small amount of gluten can damage the small intestine. The damage will occur in anyone with the disease, including people without noticeable symptoms. Depending on a person’s age at diagnosis, some problems will not improve, such as short stature and dental enamel defects. Some people with celiac disease show no improvement on the gluten-free diet. The most common reason for poor response to the diet is that small amounts of gluten are still being consumed. Hidden sources of gluten include additives such as modified food starch, preservatives, and stabilizers made with wheat. And because many corn and rice products are produced in factories that also manufacture wheat products, they can be contaminated with wheat gluten. Rarely, the intestinal injury will continue despite a strictly gluten-free diet. People with this condition, known as refractory celiac disease, have severely damaged intestines that cannot heal. Because their intestines are not absorbing enough nutrients, they may need to receive nutrients directly into their bloodstream through a vein, or intravenously. Researchers are evaluating drug treatments for refractory celiac disease.

The Gluten-free Diet

A gluten-free diet means not eating foods that contain wheat, rye, and barley. The foods and products made from these grains should also be avoided. In other words, a person with celiac disease should not eat most grain, pasta, cereal, and many processed foods. Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods. They can use potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour. They can buy gluten-free bread, pasta, and other products from stores that carry organic foods, or order products from special food companies. Gluten-free products are increasingly available from mainstream stores. “Plain” meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can freely eat these foods. In the past, people with celiac disease were advised not to eat oats. New evidence suggests that most people can safely eat small amounts of oats, as long as the oats are not contaminated with wheat gluten during processing. People with celiac disease should work closely with their health care team when deciding whether to include oats in their diet. Examples of other foods that are safe to eat and those that are not are provided in the table. The gluten-free diet requires a completely new approach to eating. Newly diagnosed people and their families may find support groups helpful as they learn to adjust to a new way of life. People with celiac disease must be cautious about what they buy for lunch at school or work, what they purchase at the grocery store, what they eat at restaurants or parties, and what they grab for a snack. Eating out can be a challenge. When in doubt about a menu item, a person with celiac disease should ask the waiter or chef about ingredients and preparation or if a gluten-free menu is available. Gluten is also used in some medications. People with celiac disease should ask a pharmacist if prescribed medications contain wheat. Because gluten is sometimes used as an additive in unexpected products—such as lipstick and play dough—reading product labels is important. If the ingredients are not listed on the label, the manufacturer should provide a list upon request. With practice, screening for gluten becomes second nature.

New Food Labeling

The Food Allergen Labeling and Consumer Protection Act (FALCPA), which took effect on January 1, 2006, requires food labels to clearly identify wheat and other common food allergens in the list of ingredients. FALCPA also requires the U.S. Food and Drug Administration to develop and finalize rules for the use of the term “gluten free” on product labels.  

The Gluten-free Diet: Some Examples

In 2006, the American Dietetic Association updated its recommendations for a gluten-free diet. The following chart is based on the 2006 recommendations. This list is notcomplete, so people with celiac disease should discuss gluten-free food choices with a dietitian or physician who specializes in celiac disease. People with celiac disease should always read food ingredient lists carefully to make sure the food does not contain gluten.

Allowed Foods
amaranth arrowroot buckwheat cassava corn flax Indian rice grass Job’s tears legumes millet nuts potatoes quinoa rice sago seeds sorghum soy tapioca teff wild rice yucca
Foods To Avoid

  • including einkorn, emmer, spelt, kamut
  • wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein
barley rye triticale (a cross between wheat and rye)
Other Wheat Products
bromated flour durum flour enriched flour farina graham flour phosphated flour plain flour self-rising flour semolina white flour
Processed Foods that May Contain Wheat, Barley, or Rye*
bouillon cubes brown rice syrup candy chips/potato chips cold cuts, hot dogs, salami, sausage communion wafers French fries gravy imitation fish matzo rice mixes sauces seasoned tortilla chips self-basting turkey soups soy sauce vegetables in sauce

* Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer. Source: Thompson T. Celiac Disease Nutrition Guide, 2nd ed. Chicago: American Dietetic Association; 2006. © American Dietetic Association. Adapted with permission. For a complete copy of the Celiac Disease Nutrition Guide, please visit

The whole life nutrition cook book is another great resource for learning how to eat gluten free please visit the link at

Points to Remember

  • People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley.
  • Untreated celiac disease damages the small intestine and interferes with nutrient absorption.
  • Without treatment, people with celiac disease can develop complications such as osteoporosis, anemia, and cancer.
  • A person with celiac disease may or may not have symptoms.
  • Diagnosis involves blood tests and, in most cases, a biopsy of the small intestine.
  • Since celiac disease is hereditary, family members of a person with celiac disease may wish to be tested.
  • Celiac disease is treated by eliminating all gluten from the diet. The gluten-free diet is a lifetime requirement.
  • A dietitian can teach a person with celiac disease about food selection, label reading, and other strategies to help manage

this information came from the The National Digestive Diseases Information Clearinghouse (NDDIC) it is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1980, the Clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. The NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication was reviewed by Ciaran Kelly, M.D., Beth Israel Deaconess Medical Center; Mitchell Cohen, M.D., Cincinnati, Children’s Hospital Medical Center; Walter Reed Army Medical Center; National Foundation for Celiac Awareness; Celiac Disease Foundation; Celiac Sprue Association/USA, Inc.; and Centers for Disease Control and Prevention staff. The gluten-free diet chart was reviewed by Alice Bast and Nancy Dickens, National Foundation for Celiac Awareness; Cynthia Kupper, R.D., C.D., Gluten Intolerance Group; and Elaine Monarch, Celiac Disease Foundation.

Well I hope this article helps to clear up any questions that you may have about celiac disease. Always contact your primary MD when changing your diet or unsure of how to check to see if you have celiac disease.

Thank you for your time and energy…..Be well

Jaime Hernandez

Health and Exercise Prescriptions Inc.


Health and exercise prescription's Blog


A Full body workout with Lifefitness machines can work for general fitness but, you should always mix in free weight training for the best results.

Why is it important to do a full body weight-bearing workout?

A full body workout includes all of your bodies major muscle groups so that your body does not have strength imbalances.  When your body gets stimulus to all of your muscle groups it helps to decrease fat, gain strength in your bones, muscles and tendons; it also helps to keep your joints lubricated so they glide better.

How many days a week should I do a full body workout?

You can start with 1-2 x a week if you are a beginner and do 1-2 sets of 15-20 repetitions. After you first 6-8 weeks doing 1-2 sets you can do 3 sets of 15-20 repetitions for another 6-8 weeks. Rest at least two days in between weight lifting sessions. After you have a half a year under your belt you can do your full body workout Monday, Wednesday and Friday starting with 1-2 sets for 6-8 weeks and then after that move back up to your 3 sets M, W, and F. That should be a great start for you to gain fitness safely. Always clear your new exercise program with your primary care doctors.

You should always warm up and cool down on a piece of cardio equipment of your choice for at least 5-10 minutes. Stretch if you have tight muscles before you get started as well.

Below are pictures of the major muscle groups you will be exercising and diagrams of  how to use the machine for each specific muscle group.


Major muscle group is Chest



Muscle group is chest



Muscle group is Lats and middle back



Lat pulldown



Muscle group shoulders



Excercise is the Shoulder press



Muscle groups are calf,hamstring,quads,hip flex, gluts






Muscle group is rhomboids middle back



Seated row



Muscle group is triceps



Tricep press



Muscle group is biceps



Bicep curl



Muscle group is hamstrings



Seated leg curl



Muscle group is quadriceps



Leg extension



Muscle group is abdominals



Ab cruncher


Points to Remember

  • Always warm up before you start exercising
  • Do not lift to much weight to start off because your body is not ready if you are a novice
  • Make sure to eat at least 1 hour before you exercise(small meal)
  • Make sure to drink at least 8-16 oz of water 45 minutes before you exercise
  • IF YOU HAVE ANY MEDICAL CONDITIONS OR PREVIOUS INJURIES GET CLEARED BY YOU M.D. and come see us at  and we can help you develop an individualized workout plan to work around your special conditions or previous injuries.
  • Make sure to get enough rest days  in; and you should not be sore more than 2-3 days
  • Make sure to get a goodnight sleep 8 Hrs, eat  meals and 2 snacks and take your  organic whole food multivitamins daily.

Well this should help you get started on your way to an exercise program that will help you gain general health. If you would like a more specific program than please contact me at 

Good luck on your new fitness adventure!

Thank you for your time and energy….Be well

Jaime Hernandez

Health and Exercise Prescriptions


Health and exercise prescription's Blog