In this KET Forum hosted by Christie Dutton, health and wellness experts explore simple, science-backed changes in diet and daily movement that can lead to lasting improvements in overall well-being. This program is funded in part by the Kentucky Medical Association.
Here are three key takeaways from the Forum:
- 1) Many people are reluctant to change their dietary and lifestyle habits because they think it would be too difficult, time consuming, or they would fail to maintain their new habits. But research shows that making small changes in the way we eat and move can, if followed consistently, have significant health benefits.
“Improving your health doesn’t have to be a major overhaul overnight,” says Dr. Angela Dearinger, a primary care physician and executive vice dean at the University of Kentucky College of Medicine. “Just making small, realistic steps can go a tremendous way in improving your health.”
Perhaps the best example of a small but impactful change is to switch from drinking sugared soda to water, Dearinger says. “A 12-ounce can of soda has about 150 calories, mostly from sugar,” she explains. Other dietary changes she recommends are to reduce portion size during meals, add one vegetable to a meal per day, limit fast foods, prepare meals at home more often, and not eat snacks out of the container but rather putting a limited amount on a plate or in a bowl.
According a U.S. Centers for Disease Control survey, more than 30 percent of Kentuckians from 2017-2020 said they did no physical activity or exercise outside of work. Carrie Davidson, a fitness manager with University of Kentucky Human Resources Health and Wellness, says the top excuse people give for not pursuing new exercise habits is that they don’t have enough time. “But the last time I checked, I have 24 hours in a day and you have 24 hours in a day, so it really comes down to priorities,” she says. “If you know someone that is exercising on a regular basis, that’s their priority. And if you’re not exercising on a regular basis, it’s clearly not your priority.”
Physiologically speaking, humans aren’t designed to sit for long periods of time. Over millennia of human evolution, Davidson says people had to move to ensure their survival, but Americans today are too sedentary. “We always say in my department, ‘Sitting is the new smoking,’” Davidson says. “The longer that we sit, the more detrimental our health outcomes are. There’s some research I was just looking at that says sedentary behavior increases your risk for cardiovascular disease by 86 percent.”
For clients who want to exercise more, Davidson says she first encourages them to increase the amount of movement they already do each day. For example, parents who attend their children’s activities should try to move while their kids are occupied – such as walking laps around an athletic field during school team practice. “We’re not asking you to add an extra hour in your day or to join a gym or spend money – just get up and do something different,” she says.
During the COVID-19 pandemic when most gyms were closed, Davidson says she and many of her clients got creative to incorporate fitness more often in their daily routines. Those small changes are good recommendations for folks just starting out on their fitness journey in 2025, she says. “Use the stairs instead of the elevator, and not just once – make that your norm,” she advises. “Park in the very back of the lot, don’t look for the spot that’s closest, whether you’re at work, the store, or the mall.”
For muscle strength, Davidson suggests incorporating six basic movements that comprise most everyday tasks into a routine and follow it consistently. She says that will boost fitness and improve a person’s chance of living independently into old age. Those movements are: squats (standing up from a sitting position), push/pull forward and backward, push/pull up and down, and bend at the waist (known as the hip hinge). “If that’s all that you get done, that’s fantastic,” she says.
- 2) Kentucky has long struggled with high rates of diabetes and obesity, and as of 2023, 13.7 percent of adults in the commonwealth were diagnosed with diabetes. Reducing high blood sugar through dietary changes is a necessary first step in preventing diabetes and the condition known as prediabetes.
Dr. Fred Williams, a retired endocrinologist, says the most valuable advice he gives people is to reduce the amount of added sugar in their diet. That will help prevent a diagnosis of prediabetes, a condition that indicates the body is having increased difficulty regulating blood sugar, which often leads to Type 2 diabetes. “You don’t go from normal to diabetic overnight,” he says, “you usually go through various stages, and one of them is prediabetes.”
Williams advises that the easiest way to cut back on sugar starts with drinks. This does not mean changing to artificially sweetened drinks, however.
“There is some research that shows that consuming too many (drinks with artificial sweeteners) may have some adverse health consequences,” he explains. “I tell my patients that on average to hold yourself to no more than three artificially sweetened beverages per day and try to eliminate or cut down on the beverages that have added sugar.”
Williams also encourages patients to avoid processed and ultra-processed foods that contain artificial colors and flavors, emulsifiers, preservatives, and additives. “Processed foods are very, very calorically dense, and they promote some changes in our body over long periods of time that can eventually lead to obesity and diabetes,” he says. According to the Network Science Institute at Northeastern University, ultra-processed foods make up 70 percent of the U.S. food supply.
The best way to change from processed foods to whole foods is to examine nutrition labels, Williams says. “If you look at a label and it’s more than five or six lines, then it’s probably an ultra-processed food – and you don’t want to eliminate all of those, but just cut back,” he advises.
Jennifer Truman, a nurse practitioner with Norton Healthcare specializing in bariatrics and medical weight management, says maintaining a healthy diet requires eating foods high in fiber in order to help regulate blood sugar. “If you think about fruit, for instance, you have the perfect package,” Truman explains. “You have nutrients, you have sugars, and you have quite a bit of fiber. Fiber is essential to balancing the blood sugar spike you’re going to get… One of the fundamentals we look at is keeping our blood sugar level as stable as possible.”
Ninety-five percent of Americans do not get enough fiber in their diet, Truman says, noting that women should consume 25 to 30 grams per day and men 38 to 40 grams. Williams recommends using a food package’s nutrition label as a guide. She advises following the “10-1 rule,” only eating foods where every 10 grams of carbohydrates equals one gram of fiber. “That’s about equal to whole grain wheat,” she says.
Another way to improve health through dietary changes is to eat foods that improve gut microbiome diversity, Truman says. Every person has a unique combination of bacteria and fungi in their gut that assist in a myriad of bodily functions. “The more we learn the more we’re kind of figuring out that (the microbiome) is connected to absolutely everything,” she says. “And when you have an overgrowth of bad bacteria or poor diversity in good bacteria, you get what we call gut dysbiosis.” Truman explains that this can lead to poor satiety (not feeling full), chronic gut inflammation leading to constipation, and other adverse health outcomes.
“The good news is that we can actually make big differences and heal our gut by incorporating the right foods,” she says. “A variety of plant foods – vegetables, fruits, nuts, seeds, whole grains, and also fermented foods… Fermented foods are foods that have live cultures in them, they are probiotics. You’re reintroducing live cultures to the gut to try to recolonized yourself with good bacteria.”
- 3) Despite the development of drugs for diabetes and obesity, there is no substitute for making permanent diet and lifestyle modifications to improve health.
In recent years, GLP-1 (glucagon-like peptide-1) drugs, which mimic a hormone produced in the gastrointestinal tract when eating, have helped patients with diabetes lower their blood sugar and helped people lose weight by reducing hunger.
Williams says GLP-1 drugs such as Ozempic and Wegovy have revolutionized diabetes and obesity care. “The problem, though, is that if you have somebody who does not want to alter their lifestyle, they just want the medication, long-term it’s probably not going to work unless they want to take these medications for the rest of their life,” he explains. “The other thing is that these medications tend to be fairly expensive, and if you look at GLP-1s as a class, there are fewer and fewer commercial insurance companies that are covering those now.”
Dearinger agrees with Williams, stressing that if a person decides to take a GLP-1 for diabetes and/or to lose weight, he or she needs to understand that doing so is a “starting point” on the new path to physical health. “(The drugs) are probably not going to be the answer for Kentucky, or for any other state,” she says. “As mentioned, Kentucky is one of the worst states in terms of physical inactivity. So, just taking the medication and continuing to be inactive is not really going to improve your health overall for your lifetime.”
The better strategy for lasting and positive change, Williams says, is for people to take ownership of their health. They should educate themselves about the best lifestyle and diet modifications to make whether they take medications or not, and avoid the quick-fix mentality. “You have to develop your own sense of motivation,” he stresses. “That, long term, is going to be a lot more effective.”
Research materials cited in this program:
- Ozempic® Prescribing Information: Non-arteritic Anterior Ischemic Optic Neuropathy (NAION), Vision-Related Adverse Events (AEs) and Ozempic® (semaglutide) injection (PDF)
- Wegovy® Prescribing Information: Gastroparesis and Wegovy® (semaglutide) injection (PDF)
