By Julie Paff, RD, LD, CDE

Paula Deen kept her diabetes secret for three years. This week Paula has made national news with her diabetes story. Long known as the 'Queen of Southern Cooking', her signature has long been "over the top decadent recipes with significant calories and fat content, like Krispy Kreme Bread Pudding and Lady's Brunch Burgers, Deen's recent disclosure brings the reality of living with diabetes to the limelight. Is diabetes caused by genetics or lifestyle? If I indulge in those decadent foods, will I increase my risk for diabetes? The resounding answer is my lifestyle decisions can increase my risk for developing diabetes or make it harder to manage diabetes if I have been diagnosed. Some risk factors cannot be modified, including:

• Age--our risk increases as we grow older.
• Genetics --there is a strong genetic link to diabetes; if our parents had it, we will be at increased risk.
• Ethnicity-persons of African American, Hispanic, Asian or Native American heritage are at higher risk for being diagnosed with diabetes.

  Other risk factors for developing diabetes or increasing diabetes management challenges include:

• Being overweight or having that 'apple shape' with a waist greater than 35 inches for women and greater than 40 inches for men. Recent weight gain increases the risk.
• Physical inactivity.
• Less healthy diet choices--including high calorie intake, high fat intake, and limited fiber intake.

Paula Deen made a powerful statement regarding diabetes….."it's not a death sentence." The fact remains that people with diabetes can live a long and healthy life if their diabetes is in good control. Diet, exercise and medication are the tools that people use to manage their blood sugar and reduce their risk of life-altering complications.

"We know so much more about diabetes today and people are being diagnosed earlier," states Becky Goldsmith, a diabetes educator and Manager of Seton Diabetes Education Program. She goes on to say, "When we diagnose the problem EARLY and manage it well, there is less time for high blood sugar to cause changes in the blood vessels that can ultimately lead to heart disease, kidney disease, changes in the eyes and nerve damage. The key is to live healthy with diabetes, and this can happen with good blood sugar control."

Paula Deen is now marketing a healthier line of recipes that are not JUST for that rare special occasion like her former line of decadent delights. She and her sons are working together to deliver fun and tasty recipes that will promote good control with diabetes-these recipes are lower in calories, fat, saturated fat, and sodium. This new line of recipes promote healthy family meals for any American seeking a healthier diet, including those with type 2 diabetes.

The POWER in Paula Deen's message is that people relate to her passion for good cooking and we all connect with the fact that GOOD FOOD can also be HEALTHY! Most people who are newly diagnosed with type 2 diabetes fear that life will never be the same and that they will need to give up food and family time they love. Often, like Ms. Deen, persons newly diagnosed with diabetes, keep the diagnosis a secret from family and friends….this is a natural reaction to this news. Becky Goldsmith states, "I hope people will benefit from Paula Deen's story and realize that diabetes does not have to disrupt a person's life and passions."

There are powerful messages in Paula Deen's diabetes story:

• Diabetes is not about giving up what we love but finding balance and moderation in our food choices. Below is an example of the former and the new lasagna-there is a BIG difference in the calories and fat, but the healthier lasagna could be at the center of any special meal!
• We may all exceed the healthy targets on a special occasion --like my birthday and Thanksgiving, but we all need to prioritize how often and how much of the decadent treats we can include to support future health. It really does come down to portions.
• Everyone needs some time to come to terms with a diabetes diagnosis and we need to arm ourselves with information on how to manage diabetes. Paula Deen went to work to learn how to manage her blood sugar and weight in an effort to improve her health before she shared her story. Diabetes education is covered by most insurance plans and can equip any person facing diabetes with tools to improve health. The research shows that diabetes education can lower blood sugar and guide people to learning their personal limits.
• Diabetes is a family affair--it is AWESOME that Paula Deen is launching her "Diabetes in a New Light Program" with her two sons, Bobby and Jaime, who are both at higher risk to develop diabetes related to genetics. The entire Deen family has lost weight in recent years and can be a model for all of us. Paula's lighter recipes will support weight loss which is proven to delay or prevent diabetes in individuals at high risk to develop diabetes.
• Diabetes can be managed--even though Paula continued to share those decadent recipes until recently, she and her sons have actually lost weight in recent years. Her healthier recipes are scaled down in portion size and contain healthier ingredients.

Let's look at a Paula Deen makeover of Mom's Lasagna (decadent) compared to Lady and Sons Lasagna (healthier). Both are from Paula Deen, but look at the difference in these two recipes!

Mom's Lasagna

Serves 6
Prep Time: 20 minutes
Cook Time: 2 hr 10 min
Difficulty: Moderate

1/2 cup olive oil
1 onion, diced
4 garlic cloves, minced
Pinch kosher salt and freshly ground black pepper
1 pound pork neck bones
1 pound ground veal
1 pound ground beef
1 pound spicy Italian sausage, loose or removed from casings
1/2 cup dry white wine
1 (28-ounce) can San Marzano tomatoes, with their juice
2 bay leaves
1 pound dried lasagna noodles
2 pounds whole milk ricotta cheese
1/4 cup chopped fresh flat-leaf parsley
1/4 cup chopped fresh basil leaves
1/4 cup chopped fresh oregano leaves
2 large eggs
1/2 cup grated Parmesan, plus more for final topping
1 pound fresh mozzarella cheese, grated

In a large Dutch oven or heavy pot, heat the olive oil over medium heat. Add the onion, garlic, and a three-finger pinch of salt and sweat them until they're translucent, about two minutes. Add the neck bones and let them brown, about five minutes. Add the ground veal, beef and sausage, and season with another healthy pinch of salt. Cook until the meat is browned, about 10 minutes. Stir in the white wine, tomatoes and their juice, and the bay leaves. Scrape the bottom of the pot with a wooden spoon, making sure to get all of the browned bits into the sauce. Season the sauce with salt, to taste, and simmer for 2 hours over medium heat. Remove the bay leaves and neck bones and let cool. Skim any fat that rises to the surface.

Bring a large pot of water to a boil over medium heat. Add enough salt so that it tastes seasoned and allow the water to return to a boil. Add the noodles and cook until al dente. Drain well and set aside.

In a medium bowl mix together the ricotta, parsley, basil, oregano, eggs, and Parmesan with a pinch of salt. Preheat the oven to 350 degrees F. Ladle about one cup of sauce on the bottom of a lasagna pan. Arrange a layer of noodles followed by a layer of sauce and then some of the ricotta mixture. Top with a layer of mozzarella, smoothing it with a spatula to the edges. Repeat the process until the pan is full. Finish with a final layer of noodles, sauce, the mozzarella, and Parmesan.

Cover the lasagna with aluminum foil and bake for one hour. Uncover and bake for 30 minutes. Remove the pan from the oven and let it rest, five to 10 minutes before serving.

Nutritional Information per serving: 1688 Calories, 85 gm protein, 115 gm total fat, 38 gm saturated fat, 1 gm trans fat, 70 gm carbohydrate, 4 gm fiber, and 1628 mg sodium.

Lady and Sons Lasagna

Serves 12
Prep Time: 30 minutes
Cook Time: 1 hour 50 minutes
Difficulty: Easy

1/2 pound extra-lean ground beef
1 (10-ounce) package cremini or white mushrooms, finely chopped
1 medium onion, diced
1 small green bell pepper, diced
2 cloves garlic, minced
1 (15-ounce) can no-salt-added tomato sauce
1 (14 1/2-ounce) can no-salt-added petite diced tomatoes
1 cup water
1/4 cup chopped fresh flat-leaf parsley
2 bay leaves (optional)
3/4 teaspoon dried Italian herb seasoning
1/2 teaspoon Paula Deen's House Seasoning
1/4 teaspoon Paula Deen's Seasoned Salt
9 whole-wheat or reduced-carbohydrate lasagna noodles
1 1/2 cups no-salt-added low-fat cottage cheese
1 cup fat-free ricotta cheese
1/2 cup grated parmesan cheese
1 large egg
1 large egg white
1 cup shredded reduced-fat mozzarella cheese
1 cup shredded Gruyere cheese (preferably Swiss or Comte)
1 cup shredded reduced-fat sharp cheddar cheese
3 tablespoons reduced-fat cream cheese (Neufchâtel), cut into small bits

To make the sauce, spray a Dutch oven with nonstick spray and set over medium-high heat. Add the ground beef and cook, breaking it up with a spoon, until the meat browns, three to four minutes. Add the mushrooms, onion, bell pepper and garlic. Cook, stirring occasionally, until any pan juices evaporate and the vegetables are softened, about 10 minutes.

Stir in the tomato sauce, diced tomatoes, water, parsley, herb seasoning, House Seasoning, and Seasoned Salt; bring to a boil. Reduce the heat and simmer, covered, stirring occasionally, until the flavors are blended and the sauce thickens slightly, 20 to 25 minutes. Remove and discard bay leaves, if using. Preheat the oven to 350°F. Spray a 9 x 13-inch baking dish with nonstick spray.

Meanwhile, cook the lasagna noodles according to package directions. Drain and rinse the noodles and lay them flat on wax paper. Cover the noodles with plastic wrap to prevent them from drying out. Combine the cottage cheese, ricotta, parmesan cheese, egg, and egg white in a medium bowl until blended. Toss together the mozzarella, Gruyere, and cheddar cheese in a large bowl.

Spread one-fourth of the sauce over the bottom of the baking pan. Top with three of the lasagna noodles. Spread half of the cottage cheese mixture, one-third of the mozzarella mixture, half of the cream cheese, and one-fourth of the sauce over the noodles. Repeat the layering once with three more noodles, the remaining cottage cheese mixture, the remaining cream cheese, one-third of the mozzarella mixture and one-fourth more of the sauce. Top with the remaining 3 noodles, the remaining sauce and the remaining mozzarella mixture.

Cover loosely with a tent of foil and bake 30 minutes. Uncover and bake until the cheese melts and the lasagna is heated through and bubbling, 10 to 15 minutes longer.

Test Kitchen Tip: To prevent the lasagna from sticking to the foil, spray the foil with nonstick spray before using it to cover the dish.

Nutrition information per serving: 260 calories, 9 grams total fat, 5 gm saturated fat, 0 gm trans fat, 23 g carbohydrate, 3 g fiber, 23 g protein, 380 mg sodium

Comparing the Facts on Two Deen Lasagna Recipes	Decadent Lasagna	Healthier Lasagna	Recommended Intake per meal
Calories	1688 Calories per serving	260 Calories per serving	500-700 for adults
Total Fat	115 gm per serving	9 gm per serving	Less than 15-20 gm
Saturated Fat	38 gm per serving	5 gm per serving	Less than 7 grams
Trans fat	1 gm per serving	0 gm fat per serving	Target as close to zero grams per meal as possible.
Carbohydrate	70 gm per serving	23 gm per serving	30-75 gm per meal depending on goals
Fiber	4 gm per serving	3 gm per serving	More than 10 gm per meal ideally with diabetes
Sodium	1628 mg per serving	380 mg per serving	Less than 700 mg per meal

Seton Diabetes Education Center offers a full range of diabetes education programs and services. If you have been diagnosed with diabetes, arm yourself with the tools you need to manage the condition.

• If you have not been through diabetes education classes, ask your doctor for a referral or call Seton Diabetes Education Center at 512-324-1891 to learn more.
• Sign up for diabetes educational support activities--Seton has a free seminar on Feb 15, 2012 entitled, Ask the Cardiologist--Getting to the Heart of Health and Diabetes. You can enroll online at www.goodhealth.com/diabetes.
• Talk to your family and let them know they can delay or prevent diabetes with healthy lifestyle choices. Take them to a Diabetes Prevention Seminar, like the ABC's of Diabetes Prevention scheduled for February 8--you can enroll online at www.goodhealth.com/diabetes

Julie Paff is a Registered Dietitian and Diabetes Educator at Seton Diabetes Education Center.