Obesity Archives - Diabetes Counselling Online

Exercise Physiologist & Diabetes

December 3, 2014 by Imagine_David Leave a Comment

So often we nit-pick at our meal plans thinking that what we eat is the problem with our blood glucose levels.

In fact our meal plan may be perfect …. but ….. our blood glucose level may not be.

For people with type 2 diabetes, more energy spent on designing & participating in a safe & effective exercise program might be the answer.

Do you have an Accredited Exercise Physiologists (AEP) on your team?

Accredited exercise physiologists (AEPs) hold a four-year university degree and are allied health professionals who specialise in the delivery of exercise for the prevention and management of chronic diseases and injuries.

AEPs provide support for clients with conditions such as cardiovascular disease, diabetes, osteoporosis, mental health problems, cancer, arthritis, pulmonary disease and more.

AEPs are eligible to register with Medicare Australia, the Department of Veterans’ Affairs and WorkCover and are recognised by most private health insurers.

********For more information about how you can access an AEP via Medicare go HERE *********

**A safe exercise plan can help with many different health problems, not just diabetes**

AEPs work in:

private clinics
hospitals
occupational rehabilitation companies
employment agencies
gymnasiums
GP super clinics
research institutes.

You might see an AEP to help you:

create a safe and effective diabetes self care exercise plan to enhance your diabetes self management
If you have pre-diabetes – create a safe and effective exercise plan to reduce your risk, or delay, the start of type 2 diabetes
overcome persisting pain caused by injury or overuse
improve your heart health
rehabilitate following a cardiac event
improve your recovery following cancer treatment
improve your general health and wellbeing.

AEPs also provide training in safe manual handling; perform functional assessments; carry out sub-maximal and maximal fitness tests; perform body composition tests and musculoskeletal assessments; and provide lifestyle education to help people manage their health conditions.

In Australia, we have the unique situation where we’re working backwards.

We have the existing resources and infrastructure including the specialised workforce of Exercise Physiologists and the Medicare subsidies which enable Australians to access these services, but we need to significantly increase our activity levels as 70% of Australians are not active enough.

Accredited Exercise Physiologists are allied health professionals, providing exercise and lifestyle therapies for the prevention and management of chronic disease, injury and disability.

**Safe and effective exercise planning is best done by the AEP**

AEP vs. Personal Trainers

Accredited Exercise Physiologists (AEPs) are not Personal Trainers.

AEPs are allied-health professionals with Medicare Provider numbers and are trained members of the health and medical sector. Fitness professionals (e.g. personal trainers) are members of the sport and recreation sector.

Personal Trainer

The Personal Fitness Trainer Qualification (Certificate 4) may be completed in less than 6 weeks of training.
Qualified and insured to design and deliver fitness programs to persons of low risk only (i.e. “apparently healthy populations”).

Accredited Exercise Physiologist (AEP)

Allied Health Provider
4 Year University Degree qualified and accredited with ESSA.
Specialise in graded exercise therapy and lifestyle interventions for persons at risk of developing, or with existing chronic and complex medical conditions and injuries (i.e. ‘specific populations’).

**Safe and effective exercise can assist with the maintenance of a good quality of life**

Questions to ask your AEP

How much experience do you have in helping people living with diabetes create safe and effective diabetes self care exercise plans?
What do you need from me to give me the safest advice?
Will you work with me and my other health care professionals e.g. diabetes educator , dietitian, doctors to enable everybody to understand the plan and to guide me safely with this plan? Can you write the plans and advice for me so that I can show my other health care professionals what we are doing?

Kind Regards,

David

Diabetes Educator @ Diabetes Counselling Online

Please Share!

Eating well without counting calories

August 11, 2014 by Sally 2 Comments

Some of us really dislike counting calories. It’s great for those who do, and many I know use tools/apps such as MyFitnessPal and others with success, but it’s not for everyone. This raises the question, if you’re not counting calories how do you know how much to eat to lose or maintain your weight/wellbeing?

A good place to start is to have an understanding of the energy density in carbohydrates, proteins, fats and alcohols, these being the four ‘macronutrients’ that provide all our calories/energy in the food we eat. May I suggest a quick review of a previous blog called ‘Energy In/Energy Out – understanding how much you need and where you get it’. In a nutshell though, carbohydrates and proteins provide about the same amount of energy, and fats and alcohol are about double the energy density of carbohydrates and protein.

Another excellent thing to keep in mind is the Australian Dietary Guidelines that indicates how many serves of each of the five food groups each of us should be aiming to include in our daily food intake.

The reason for highlighting this suggestion is it is easy to think that because something is healthy that means we can eat as much of it as we like. We know that monounsaturated and omega-3 polyunsaturated oils, including avocados, nuts and seeds, are good choices for heart health (as outlined in the Blog 2 on fats – which are the best types for us to enjoy?). Often if people think they’ll lose weight by cutting out one macronutrient, it just doesn’t work in the long term as they tend to balance out the energy they need by including more of another.

For us with diabetes, often people think they should cut down on their carbs to help with their blood glucose control (which can be helpful – read more in the blog Discussion on low carb diets) but end up eating more fat or protein in their daily routine to make up for the energy they’re missing in the carbs they’ve cut.

So the idea to understand how to make your meal and snack choices contain the correct amounts of the ‘macronutrients’ to keep your energy balance as well as the foods from all 5 food groups to provide you the nutrition you need for wellbeing.

The key, as always with diabetes, is ‘balance’.

There are a number of plate diagrams around. The traditional idea of a medium sized plate divided into quarters, with one quarter being carb foods (preferably nutritious and low-GI), one quarter being lean protein and the other half being non-starchy vegetables, with a small amount of good fats too is an awesome idea to keep in your mind.

The Australian Dietary Guidelines also reminds us that “an allowance for unsaturated spreads and oils for cooking, or nuts and seeds can be included in the following quantities: 28-40g per day for men less than 70 years of age, and 14-20g per day for women and older men.”

Carbohydrate foods

Choices here can come from the vegetables, grains, dairy and fruit (although we tend to save dairy and fruit for snacks). You might choose sweet potato, Carisma potato or sweet corn if you were having a vegetable based meal, and around 2-3 carb serves of these would make up the quarter serve of your plate. If you were having rice, pasta or another grain food, again you’d aim for 2-3 carb serves on your plate.

It’s easy to think about carb serves as roughly a small fist size.

Protein foods

One serve of a protein food as outlined in the Australian Dietary Guidelines is enough to take that quarter allocation on your plate:

65g cooked lean red meats such as beef, lamb, veal, pork, goat or kangaroo (about 90-100g raw)
80g cooked lean poultry such as chicken or turkey (100g raw)
100g cooked fish fillet (about 115g raw) or one small can of fish
2 large (120g) eggs
1 cup (150g) cooked or canned legumes/beans such as lentils, chick peas or split peas (preferably with no added salt)
170g tofu
30g nuts, seeds, peanut or almond butter or tahini or other nut or seed paste (no added salt)

You can read more about protein in the blog Protein and diabetes – do you get the balance right?. And it can be easy to think about protein serves by aiming for a serve the size of the palm of your hand (no fingers or thumbs).

Non-starchy Vegetables

This section is half the plate, and is where many people struggle to eat enough. It should be made up of about 3 serves based on the Australian Dietary Guidelines, and doesn’t include the starchy veggies that sit in the carbohydrate quarter.

A standard serve of vegetables is about 75g or:

½ cup cooked green or orange vegetables (for example, broccoli, spinach, carrots or pumpkin)
½ cup cooked, dried or canned beans, peas or lentils
1 cup green leafy or raw salad vegetables
1 medium tomato

Some great ideas to make the non-starchy vegetables work for you might include roasting them or a vegetable stew or curry with a tomato base. And there’s always a hearty salad with perhaps some cheese from your daily dairy serves, or good old lightly steamed vegetables. You can also skewer them to be barbequed, and stir fry them – the options are almost never ending.

So don’t be held back by some maybe old-fashioned ideas about vegetables not being exciting. Give some new ideas a try and learn to embrace their wonderful nutritious and delicious qualities. And if at the end of a meal, or even in between meals, if you can discover some ideas for these non-starchy vegetables you’ll be happy to learn that they’re low in all the energy containing macronutrients so eat more of these to keep you satisfied.

How much weight is a good amount to lose?

This is really a topic for another whole blog, but just briefly I’ll take the opportunity to remind you that ‘going on a diet’ doesn’t work in the long term. Even if you lose weight in the short term, it will come back plus some – the evidence here is overwhelming. By following the Australian Dietary Guidelines suggested daily serves for your gender/age and participating in regular physical activity you are likely to lose about a kilo a month and it should be sustainable. There is certainly a lot to eat in there and I challenge anyone to still be hungry when consuming all that food! To maintain a healthy weight it’s recommended that you add in 2.5 serves from the food groups that you enjoy the most.

The main point is to avoid processed and take away foods as often as possible. Try to be organised and take your own meals and snacks with you to help avoid temptation.

My last key point is to remind you about the importance of seeing an Accredited Practising Dietitian to help you with a personalised consultation so you know you’re getting everything you need to be your best.

I hope you’ve found this useful in helping you to understand how much of the different foods you need to include in each of your meals, as well as the extras you have such as dairy, fruit and nut serves for your snacks if you need/want them.

Please let me know if you any questions. Wishing you all an awesome week. Sally

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a list of all Sally’s Diabetes Counselling Online blogs here.

Please Share!

Discussion on low carb diets

July 28, 2014 by Sally 8 Comments

Australian Guide to healthy eating poster

By popular demand through a thread in our Facebook group Diabetes and Food – let’s celebrate it!, this topic deserves a blog to help explain some of the ‘stuff we hear’ around carbohydrates and type 2 diabetes. I’d also encourage people with type 1 diabetes to read this though, because some of the points made are also relevant for us! Up front I will remind you that everyone has individual requirements and should see an Accredited Practising Dietitian for a personalised consultation, so this is a ‘general guide’ only.

Firstly we need to understand what ‘low’ means in such a context as in my experience as an Accredited Practising Dietitian, people tend to associate ‘low’ with ‘virtually no’ carbohydrate. We’ll also look at some of the evidence that shows that ‘low’ carb diets can help with glucose control in type 2s, and why when drugs (other than metformin or SGLT2-inhibitors) are introduced it’s important to ensure more (quality) carb intakes as advised by your health professionals. And lastly (but certainly not leastly) we’ll review how, based on the Australian Dietary Guidelines, it’s possible to have a nutritionally balanced diet while watching your carb intake.

What does ‘low’ carbohydrate mean?

If you ask some people what they think ‘low carb’ means, you may hear that it’s about cutting carbohydrates out as much as possible. Straight up as a dietitian my alarm bells ring as carbs feature in all five of the food groups that we need for nutrients to ensure our wellbeing: vegetables (starchy vegetables like potato, sweet potato and corn), fruit, dairy, protein (when the likes of legumes are included, and especially in vegetarian diets) and of course, the important grain/cereal foods.

The American Diabetes Association defines a low-carb diet as 130g of carb per day. Does that surprise you?? The ‘trick’ with low carb diets is therefore to know how to choose your carbs wisely so that you’re still meeting your nutrient requirements, and also to know what to replace that carb energy with (remembering that carbs, proteins and fats make up our daily energy intake) so you don’t get too hungry and be encouraged to ‘cheat’.

Remembering that there’s 15g of carbohydrate in an ‘exchange’ or ‘serve’ that gives us close to 9 carb serves across the day.

If you’re on medication that helps your body to produce more insulin, or you’re providing insulin yourself on a fixed dose then this idea is dangerous to your health so please speak to your health professionals before making any changes to your diet.

Some benefits of lower carbohydrate diets

Of course we know that all carbohydrates break down to glucose which is the fuel needed by our bodies, but in modern diets often too much (and poor quality) of this ‘fuel’ is provided which can cause stress to our organs and worsen our diabetes control. So understanding the benefits of a lower carbohydrate diet can help us to stick with it for longer and balance the rest of our diets more easily.

Some of those benefits may include:

Lower incidence of high blood glucose levels (hyperglycemia)
Lower amounts of medications need to control hyperglycemia
130g/day is a sustainable amount, meaning it’s easier to stick to in the longer term
Putting your pancreas under less stress to produce insulin, thereby helping it to keep working for longer
By ensuring your 130g/day is nutritious and low-GI carb you may also improve your blood fat levels (cholesterol/triglycerides) which will lower your risk of cardiovascular disease
It doesn’t necessarily lead to weight loss – that depends on your total energy intake.

How do you manage it best?

Again I will mention how important having a personalised consultation with your Accredited Practising Dietitian is because everyone is different in many ways. Here I will make suggestions that I hope will help to get your head around combining the idea of low carb into your daily routine while still meeting the nutritional requirements as outlined in the Australian Dietary Guidelines foundation diet (see page 2).

In a nutshell, it’s about only choosing your carb sources from the 5 food groups and balancing that out with quality proteins and healthy fats. I encourage you to re-read the previous blogs I’ve written on those topics as highlighted.

Remembering that 130g/day equates to close to 9 carb exchanges/serves, your day might start to look a bit like this:

Breakfast: ¼ cup of raw rolled oats (1 serve carb) served with 125ml light milk (half a serve), a small banana (85g – 1 carb serve) and a tablespoon of LSA mix (for extra fibre/protein) = 2.5 serves total

Morning Tea: A 100g tub of low-fat yogurt = 1 serve total

Lunch: A sandwich made on wholegrain bread (the grainer the better – 2 serves) made with a protein serve and as much non-starchy veg as you can handle, either on the sandwich or as a side, using half an avocado as the spread (for your good fats), and a piece of fruit such as an apple or pear (both good low-GI fruits – 1 serve) = 3 serves total

Afternoon Tea: A 30g handful of mixed unsalted nuts = not worth counting carb-wise

Dinner: Remembering the balanced plate being one quarter carb, one quarter protein and half non-starchy vegetables, this works with so many meals. Aim for your carb serve to = 2 serves total

Supper: You’ve still got half a carb serve up your sleeve. I would encourage something like half a slice of grainy toast with peanut butter on it to give you the energy to get you through the night, but half a serve of low-fat dairy would also work well, or even a couple of squares of dark chocolate if you fancied it = 0.5 serves total

In this example you can see that we’ve incorporated 9 carb serves/exchanges and yet have included quality carbs at every meal.

Some final tips

Remember to include protein and some non-starchy veg with every meal.
Rice and pasta can be problematic a serve size is so small. Something I recommend that works for many people is to include the carb serves in the form of legumes (lentils, chickpeas, kidney beans, etc) in the pasta sauce and use low-carb alternatives such as those made from konjac root, or make pasta/rice out of vegetables such as grated zucchini or carrot or cauliflower. I sometimes serve my pasta sauces on mashed cannellini beans and frozen spinach (warmed of course!) and find it’s very satisfying.
Don’t forget to exercise! If the point of minimising your carbs is to control your BGLs, then even as little as ten minutes exercise after meals can make a fantastic difference to your readings. Do some self-experimenting about how much your BGLs drop after say 10, 20 or 30 minutes walking after meals, and then if you want to include more quality carbohydrates in some meals, you’ll know how to manage better.

I hope this has proved useful for you, and that you have a better understanding of how a low-carb (130g/day) might help with your diabetes control. Of course please ask any questions below and I’ll be happy to address them for you.

Please Share!

Rave about the glycemic index

June 23, 2014 by Sally 1 Comment

Recently I’ve been hearing a few people raving about the benefits of including low-GI carbs regularly in our food intake, and you may have realised by now that I am a HUGE fan of them and include low-GI carbs in every meal that I eat (wherever possible) as I personally see the results in minimised fluctuations in my blood glucose levels, in my weight maintenance and in my cholesterol tests. So I thought it might be a good time for a ‘reminder’ blog for those less experienced in the glycemic index Hopefully others of you may get a ‘light-bulb’ moment by a new idea too!

For those of us taking insulin, I also like to raise consideration of the action time of the insulin that we dose for the carb that we choose, bearing in mind that most of the fast acting insulins remain active for about three hours. So if you can match the action of the carbs as closely as possible to the action of the insulin then it makes sense that your BGLs remain more stable, and low-GI carbs help make this possible.

I’ll start with a summary of some previous blogs on the topic, and demonstrate using real life examples from our Diabetes Counselling Online closed Facebook group Diabetes and Food – let’s celebrate it!

My first blog on the topic of the glycemic index, back in November last year (one of three) was called ‘How low can you go? Benefits of low-GI carbohydrate sources’. In it I explain what the glycemic index means and how it affects our blood glucose levels, as well as listing several other benefits that have been demonstrated with over 30 years of research into the topic:

Help to fill you up and keep you feeling satisfied for longer, helping you to avoid over eating or too much snacking
Lower your required insulin levels which makes fat easier to burn and less likely to be stored
Help you to lose body fat and maintain lean muscle tissue
Reduce your triglycerides, total and ‘bad’ (LDL) cholesterol
Increase your levels of ‘good’ (HDL) cholesterol
Reduce your risk of developing type 2 diabetes, or for us with type 1, slow down the chance of insulin resistance or ‘double diabetes’ (not a technical term).
Help to manage your blood glucose levels and reduce your risk of developing diabetes complications
Reduce your risk of developing cardiovascular disease
Reduce your risk of developing some cancers
Reduce your risk of developing certain eye diseases
Improve your skin
Sustain your energy levels longer, improving both mental and physical performance

In the second blog in the series, called ‘Choosing to go low – making the change to low-glycemic index carbs’, I explain that the great thing about making the change to low-GI is that it’s not a diet but more a way of eating. It’s not restrictive, and if you can learn to recognise when foods are likely to have a lower glycemic index, then you’ll be able to make better choices. It doesn’t cut out any major food groups so we’re still following the Australian Dietary Guidelines. I talk you through the five major food groups and how to include the low-GI carbs from them in your meals and snacks, as well as how to manipulate the glycemic index of your meal. It’s a really helpful blog

The third in the series, called ‘Closing the GI loop – quality + quantity of carbohydrates’, reminds us that for our blood glucose control we need to manage not only the quality of our carbohydrates by choosing low-GI and nutritious carb sources, but also the amount we’re having. It explains how the glycemic load works.

Then a few months later I attended a lecture by Dr Alan Barclay of the Glycemic Index Foundation and wrote an update blog, called ‘An update on glycemic index and glycemic load’, which referred to recent research on the topic as well as including further explanations such as that the glycemic index compares equal quantities of available carbohydrate in foods, is a measure of their effect on blood glucose levels in 10+ healthy people over a 2 hour period, and is expressed as a percentage.

The GI Ranking of individual foods is:

55 or less = Low GI
56-69 = Moderate GI
70+ = High

We talked further in this blog about glycemic load (GL) and that it’s important to remember that the higher the GL, the greater the elevation in blood glucose AND insulin levels, so it’s worth keeping an eye on. It also talks about the requirements for companies to use the low-GI symbol on packaging and has a link to subscribe to the free e-newsletter published by the Glycemic Index Foundation, GI News, that I would encourage you all to subscribe to.

If you’re looking for low-GI food ideas, the GI Foundation website not only has a special section for diabetes, but also some great recipes and many other hints and tips including a SWAP calculator to help you find a lower-GI alternative to your favourites AND this awesome shopping list.

How do you keep your BGL’s stable?

To finish up, last week in the ‘Diabetes and Food – let’s celebrate it?’ closed Facebook group I asked people to comment on ‘which foods you include every day for the reason that you know they help keep your blood sugars more stable’. Not surprisingly all the foods that people spoke of were low-GI. Some examples that people spoke of were:

Natural foods – lots of fresh veggies, fruits and oats. I also find that sour dough rye bread is really good for me – doesn’t affect my levels too much
I have found too that rye bread is good for keeping my sugars in check. One thing lately has been oats for breakfast. Keeps me full and I don’t get that spike in my levels
Oats, dairy and fruit for breakfast – a good start for the day!
Vegetables, as many as I can fit into my diet
Porridge for breakfast, Soup for lunch, Apple orange and nuts during the day and muesli cookies with my late night cuppa
Bananas
Thanks for the suggestion of sour dough rye! I love my oats for breakfast and in winter soup for lunch
Almonds as snacks, Greek yoghurt in my breakfast, things in my salad like kidney beans and chick peas, sweet potato by the bagful
That with an apple for morning tea is my 2 serves of fruit plus extra fibre
Porridge for breakfast, salad sandwich on raisin bread for lunch, fruit for snack and soup for dinner most days anyway
We like to have porridge which is great for our child’s readings
Nuts and avocados

Thanks for such great ideas team! Isn’t it great how everyone is understanding that the low-GI carbs helped to keep their blood glucose levels more stable? How do you do it?

Sally Marchini is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), has had type 1 diabetes for close to 40 years and coeliac disease for many years too.

Please Share!

Fibre is our d-friend

June 16, 2014 by Sally Leave a Comment

I’m sure you’ve all heard about the importance of including good levels of fibre for good digestive health, so I thought it worthwhile to talk through the different types of fibres and how they benefit us as well as what the evidence says about fibre in relation to diabetes and how much we need topped off with some ideas of how you can increase the fibre in your diet for your improved wellbeing. Many of my previous Diabetes Counselling Online blogs have referred to fibre, so I’ll remind you of those along the way and you might like to bookmark them for a re-read.

It’s important to remember from the start that when following a high fibre diet that you drink plenty of fluids (preferably water) and are physically active to help you gain the greatest benefits.

Fibre and Diabetes

Starting with the glycemic index, we should know that including foods higher in fibre will contribute to lowering the glycemic index of the carbohydrates in the meal. You can read more about this topic here and here.

There’s also lots of evidence that you can read about in the Australian Dietary Guidelines about how fibre reduces fat absorption and reduces risk of cardiovascular disease and bowel cancers. All of these are important issues for us with diabetes to consider.

And, of course, if you’re watching your weight, fibre has a lower energy density as it resists digestion so will keep you feeling satisfied for longer too.

Types of Fibre and their roles

Dr Alan Barclay of the Glycemic Index Foundation explains that “dietary fibres come mostly (but not exclusively) from plants and that they are the poorly digested portions that pass through into the large intestine (bowel) and provide much of the bulk in our stools (along with water and bacteria, amongst a few other things).”

There are three main types of dietary fibre: soluble, insoluble and resistant starch. We need a combination of these for good health as they play separate roles.

Soluble fibres attract water and are totally broken down in the large intestine (colon) by good bacteria. They include foods such as whole grains, legumes, psyllium, some fruits, vegetables, nuts and seeds. You can read more here.

Insoluble fibres are the ‘bulking’ fibres that aid regular bowel movements. They are also found in similar foods as the soluble fibres, but wheat bran is also a contributor.

Resistant starch is like fibre in that it is starch that resists digestion in the small intestine and travels through to feed the good bacteria in the colon. Research is indicating how beneficial it is for colon health! It’s found primarily in legumes, pearl barley and brown rice as well as cooked and cooled starches (the process forms a crystalline structure around the starches, causing them to resist digestion) such as potato, pasta and rice. The CSIRO has developed a type of this starch which can be found in some specially formulated breads and cereals (including the BarleyMax range by Goodness Superfoods).

How much do we need?

I usually advise clients to read labels (most labels in Australia include fibre these days) and look for the highest fibre level when you’re comparing products. You can read more about label reading in a previous blog here.

As a guide, breads should be greater than 5g/100g at a minimum.

In total we’re aiming for 28g per day for women and 38g per day for men.

How do we get it?

If you aim to include fibre-rich foods such as wholegrains, legumes, nuts, vegetables and fruit in each of your main meals, and follow the Australian Dietary Guidelines, especially in those 3 food groups, you should easily reach your target. Leaving the edible skins on your fruit and vegetables is also an awesome idea.

I couldn’t do better than share this table from the Grains & Legumes Council website with you to demonstrate how to include more fibre…

(Just click on the picture to enlarge it if it’s too small for you to see clearly)

High fibre recipe ideas

The most basic idea is to modify existing recipes by adding products like legumes and whole grains and nuts and seeds, but here are some high-fibre recipe links that might inspire you to increase your fibre intake.

Cinnamon Chicken with Bean Salad

Apple and Bran Muffins

Mushroom and Lentil Burger

There’s loads more this like this on the Taste.com.au website, as well as my other favourite internet recipe sites including Allrecipes.com.au, the Grains & Legumes Nutrition Council website and the Nuts For Life website.

Some other helpful links for more info on fibre

Dietitians Association of Australia

Grains & Legumes Council

The Better Health Channel, Victoria

Catherine Saxelby’s Foodwatch website

The Australian Healthy Food Guide by dietitian Caitlin Reid

Hoping that’s given you inspiration, understanding and some helpful ideas to include more fibre in you day.

We’d love to hear how you personally get enough in your day, so please share in the comments below.

Wishing you a great day! Sally

Please Share!