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Diabetes video series
If you are living with diabetes, you're not alone - it affects millions of Canadians. But it's a complex condition that impacts everyone a bit differently. In our new themed video series, we strive to cover all the basics, hot topics and key diabetes management skills necessary to answer your questions and to empower you to manage your diabetes in your own way. The video series listed below is intended for people living with diabetes and diabetes caregivers. Stay tuned to our YouTube and social channels for when each series launches.
View mental health video playlistwelcome to the mental health video
0:09
series for people living with diabetes
0:11
my name is Candace and I'm from diabetes
0:13
Canada talking about your diabetes care
0:16
with your support team can be
0:17
challenging especially when stigma can
0:19
get in the way this session will provide
0:21
strategies for engaging with your
0:23
Healthcare team and others who support
0:25
your management to ensure your needs are
0:27
met Cassandra Millan registered social
0:29
work worker and psychotherapist with
0:31
over 15 years of experience has been
0:34
living with type 1 diabetes for nearly
0:35
30 years she will explore how person-
0:38
centered care approaches can help people
0:40
with diabetes have competent
0:42
conversations with their Healthcare team
0:44
over to you
0:45
Cassandra hey thank you so much for
0:48
being here we're so excited to be able
0:50
to offer this um because we know how
0:54
difficult these conversations can be to
0:56
have in the context of healthcare it's
0:58
hard to speak up and it's hard to kind
1:01
of know if we're allowed to say things
1:03
or what we're allowed to say and so
1:05
today we are going to talk about how we
1:08
have more confident conversations with
1:11
our providers and with our care teams so
1:13
that we really feel like our healthc
1:15
care is working for us um as well and so
1:19
just an overview of some of the topics
1:21
that will be covered today we will spend
1:24
some time just talking about what is
1:25
person centered care um and how do we as
1:29
patients
1:30
um and people fit into that we'll also
1:33
spend some time talking about how do we
1:35
manage stigma around living with
1:38
diabetes um whether that's type one or
1:40
type two when it comes up um and
1:44
hopefully it's not coming up as often
1:46
but it's really difficult sometimes when
1:48
it
1:49
does we'll also spend some time today
1:52
talking about how do we speak up what
1:55
are some things that would be important
1:57
to know so that we can Empower ourselves
1:59
to have these conversations with those
2:02
on our care team and those who are in
2:04
our Circle um when we are maybe
2:07
intimidated to do so or feel like we
2:09
don't have a right to speak up um or we
2:12
feel like we might not be heard and then
2:14
what are some actual strategies that we
2:17
might have um to start these
2:20
conversations what are some ways that we
2:22
can present um our personal experience
2:26
as somebody living with
2:28
diabetes first we want to talk about
2:30
person- centered care and often times
2:34
person- centered care might be thought
2:36
of as um you know the person living with
2:40
diabetes has full decision-making power
2:44
and what we really mean with person
2:45
centered care is that there's a
2:48
recognition that individuals are a
2:51
valuable part of their care they're a
2:54
valuable resource you're a valuable
2:56
source of expertise you are the expert
2:59
of your life
3:00
as the person living with
3:02
diabetes and we want to blend that into
3:05
this Matrix of clinical expertise you
3:09
know what your provider also knows and
3:11
what they bring to the table as well as
3:13
research-based practice right what has
3:16
years and years of research shown us can
3:19
be effective and helpful and when we can
3:21
put all of these things together we can
3:24
really land in the center of the ven
3:26
diagram that you see here and it Honors
3:29
that what works best for somebody else
3:32
might not work best for you and that's
3:34
also a valuable source of information
3:37
and a valuable source of
3:38
knowledge when we talk about person-
3:41
centered care we talk about
3:43
understanding the context of your whole
3:47
experience and so some examples of that
3:50
might be you know if you're a single
3:52
parent and living with type one or type
3:56
two diabetes and you have um you know
4:00
limited support overnight and maybe you
4:02
have young
4:04
children for you it might work a little
4:07
bit more effectively to have your blood
4:10
sugars in a different place than
4:12
somebody else going to bed and that
4:15
understanding and being able to talk
4:17
openly about that would be an example of
4:21
your experience you knowing yourself and
4:23
your needs best that your provider might
4:26
not know and then when they say they
4:28
don't they might not know it's not that
4:30
they might not care it's that they just
4:32
might not have thought of that um or
4:35
maybe you're an athlete who needs your
4:37
blood sugars in a certain range in order
4:40
to perform in the ways that you want and
4:43
it might be a little bit different than
4:45
what research suggests and you recognize
4:48
that that's what works best for you for
4:50
whatever reason um these are all
4:53
examples of you knowing yourself um well
4:57
as a person living with diabetes and
4:59
that source of information and expertise
5:01
is highly
5:03
knowledgeable when we talk about person-
5:05
centered care we really want to Anchor
5:07
into this idea that we're having
5:09
conversations to learn and understand um
5:13
not conversations that are based on
5:16
telling somebody what to do right having
5:19
conversations in the sense of learning
5:21
to understand not learning to respond
5:23
and I think when we can integrate that
5:26
into the patient experience um by
5:29
advocating for ourselves then we can
5:31
start to feel less isolated in our care
5:36
um and when we feel less isolated we are
5:39
at lower risk perhaps of things like
5:42
diabetes distress or other mental health
5:45
um challenges that might come with
5:47
living with diabetes right we might feel
5:49
less anxious going to an appointment
5:51
when we feel like our experience and our
5:54
expertise on our own um selves is being
5:58
heard
6:00
when we can feel like a part of our care
6:04
we also are in a position to perhaps
6:07
feel more connected and from a mental
6:09
health standpoint we know that
6:11
connection is so vital um when we're
6:13
working through difficult things it is
6:16
one of the things that really anchors
6:18
anybody into um not having as longterm
6:23
or um as negative perhaps repercussions
6:27
of something really difficult and so
6:28
when we can have these conversations
6:31
when we can feel like we are involved in
6:34
our care when we can feel like our
6:36
experience matters um then we're at
6:40
lower risk of feeling disconnected lower
6:43
risk of feeling isolated lower risk of
6:45
feeling Alone um in our journey as
6:48
somebody living with
6:51
diabetes so when we think about stigma
6:54
with diabetes I think you know if you're
6:57
watching this most likely you've
6:58
experienced it and stigma you know in
7:02
its purest form is really just this Mark
7:05
of disgrace or shame that comes with a p
7:10
particular circumstance um or
7:13
quality um and it's way more common with
7:16
diabetes than I think anyone would like
7:19
to admit and some things that can often
7:22
Drive stigma might be the perception
7:26
that a medical professional is the
7:28
expert um you know as opposed to what
7:32
you can contribute as we talked about a
7:34
few minutes ago with person- centered
7:36
care and a person with that personal
7:39
lived
7:40
experience lack of awareness or lack of
7:43
knowledge around the experience of
7:44
diabetes can also Drive um that
7:48
experience with stigma and you know I'll
7:51
share an example of when I was in high
7:53
school um I had a science teacher who
7:56
was talking about his weight loss
7:59
Journey and um how he cut out sugar and
8:02
of course he had to cut out sugar
8:03
because if if he ate sugar continuously
8:07
then he was no doubt going to get
8:10
diabetes right and you know all with
8:13
good intentions I'm very well aware of
8:15
that but as a 16-year-old in the back of
8:18
the science class when you see all the
8:20
heads turn back and start asking you oh
8:22
my gosh is that why you have diabetes
8:24
did you eat too much sugar as a kid
8:26
these are things that come up and
8:28
unfortunately for a lot of people have
8:30
also come to either be expected or
8:33
normalized um in the experience of
8:35
living with diabetes and again this is
8:38
um not unique to type 1 diabetes or type
8:41
two or gestational it happens across the
8:44
board sometimes personal health beliefs
8:47
um for people that are important to us
8:50
might also filter into our relationships
8:53
which can enhance that sense of
8:55
stigma um and access to credible
9:00
information and so there's a lot of
9:02
wonderful resources out there on the
9:05
internet um and there's also a lot of
9:07
misinformation on the internet about
9:09
things that might lead to the
9:11
development of diabetes or what is
9:13
appropriate care or what puts somebody
9:17
at risk um and all of these things can
9:20
contribute again to that purest form of
9:23
stigma which is a sense of disgrace
9:26
related to having or living with
9:27
diabetes
9:29
there's also a lot of confusion around
9:32
the different types of diabetes um so
9:34
there are significant differences in
9:37
some ways between type one and type two
9:40
um and that confusion can again fuel
9:43
that stigma um of living with diabetes
9:48
or how you manage your
9:49
diabetes um as a type 1 diabetic I often
9:53
get asked by people that um I know with
9:57
type 2 diabetes around management and
9:59
and it can be different and I think even
10:01
you know in the context of people living
10:03
with diabetes there can be some
10:05
confusion about the differences um that
10:07
again has high potential to increase um
10:11
some of that stigma or that sense of
10:13
being judged
10:15
or some of that shame in some
10:19
aspects sometimes stigma can also lend
10:23
itself
10:24
to you as a person living with
10:27
diabetes when there's High stigma or
10:30
even an isolated experience of being
10:33
stigmatized as a person living with
10:35
diabetes you know uh misinformed
10:38
judgment a comment about um someone's
10:42
sugar consumption live leading to the
10:44
development of
10:45
diabetes all of these things can lead to
10:48
um unhelpful belief that diabetes is the
10:52
individual's fault when in reality we
10:54
know that there's lots of things that
10:56
might contribute and we also know that
10:58
in some circumstances we don't know what
11:01
contributed and the risk that we run
11:03
when we start to internalize that belief
11:06
or some of these um stigmas that come up
11:09
in our everyday interactions is we start
11:12
to experience High shame or self-blame
11:17
we start to disconnect or we might feel
11:19
more isolated we might feel like other
11:21
people don't understand or what's the
11:23
point in
11:24
Sharing um or we might even come to
11:27
expect these things to a point that it's
11:29
normalized and we don't perhaps deal
11:31
with it in the ways that are helpful and
11:33
all of these things can contribute to
11:39
um more significant um challenges
11:43
perhaps with things like I'm feeling
11:45
anxious going to an appointment um
11:49
difficulty talking about diabetes with
11:51
others worries around being judged if we
11:54
share that we have diabetes all of which
11:56
I think we can all agree are
11:59
not helpful in the context of mental
12:02
health so we start to internalize it we
12:05
start to expect it or normalize it we
12:08
start to feel like perhaps feel like
12:10
we're part of the problem or we are the
12:13
problem um or we start to blame
12:15
ourselves which is also a really tricky
12:17
and unhelpful place to be I think
12:20
another example that's worth mentioning
12:22
is often women who have diabetes um in
12:26
pregnancy whether they've developed it
12:27
before whether it's um gestational
12:31
diabetes they you know there's this
12:33
stigma that they will have bigger babies
12:35
and I think the research shows that but
12:39
if you have a bigger baby often the the
12:41
question might be you know gosh you know
12:45
where your blood sugar is out of
12:46
control um and that's not a helpful
12:49
question and it also might not be
12:52
accurate at all and so I think this is
12:54
just a really good example of that
12:56
stigma that could leave that mother
12:59
um you know who just had a baby um
13:02
feeling like something was their fault
13:04
you know my baby was bigger because I
13:06
didn't do something um as opposed to the
13:09
reality of it might not have been the
13:12
case at all baby could be perfectly
13:14
healthy um but that's again is just
13:17
another example of how common that
13:19
stigma can be and it's it's most often
13:22
not ill intended um but the way that we
13:25
perceive it or we internalize it can be
13:27
really challenging
13:31
so how do we speak up right or why is it
13:34
important that we speak up um so that we
13:38
can get care that really works and makes
13:40
sense for
13:42
us when we start to internalize that
13:45
stigma as we were just talking about
13:47
that can really deter somebody from
13:49
speaking up can also lead to feelings of
13:52
hopelessness you know or that sentiment
13:54
of what's the point no one's going to
13:55
listen or I'm not going to feel heard no
13:57
one gets it um this isn't working for me
14:01
these are all um examples of perhaps a
14:05
felt sense of hopelessness that can also
14:08
deter us from advocating for ourselves
14:11
speaking up to get care that really
14:13
makes sense for
14:15
us it's important to speak up even when
14:18
we feel this that's usually a good
14:20
indicator that we need to speak up
14:22
because our situations do change and we
14:25
need to acknowledge that for ourselves
14:28
we also need to acknowledge that it's
14:29
okay if our situation has changed and we
14:32
need to communicate that with our
14:34
healthc care team because they may not
14:37
know right if you haven't seen your
14:40
health care provider for a number of
14:42
months um they might not know that your
14:45
situation has has moved in this way or
14:48
that you're dealing with something else
14:49
or that your support system has altered
14:52
in some way and so it is important that
14:55
we let um our Healthcare Providers know
14:58
these things
15:00
I think it's natural as an individual to
15:03
have our own assumptions about how our
15:06
healthc care providers might work with
15:07
us and you know that connects back to
15:10
what we were talking about with stigma
15:13
and sometimes that you know power
15:15
imbalance of well this is the doctor
15:17
this is the the expert in their field um
15:20
who am I to come in and share my
15:22
personal experience that might not
15:24
completely connect with you know what
15:27
I'm anticipating they might say
15:29
but when we can start asking those
15:31
questions of how would this fit in if
15:34
this is my experience then we can start
15:37
to open the conversation up to do things
15:40
differently at the end of the day any
15:42
individual or any patient has the right
15:44
to feel heard and to ask for what they
15:46
need and it doesn't always mean that
15:48
these things play out in the ways that
15:52
um you know we might expect because we
15:54
might get an answer that we hadn't
15:55
thought of as a as an individual or as a
15:58
patient but it helps us feel more
16:00
connected to our provider um when we can
16:03
start to really help them to understand
16:06
as well how that would unfold in our
16:09
unique circumstance or our unique um
16:11
situation or life right I always think
16:15
you know the thing that always comes to
16:16
mind is we don't know what we don't know
16:18
and that's true for us and that's also
16:19
true for our healthc care providers um
16:22
who are trying to help us and so it is
16:23
important that we try to speak up and
16:26
and let them in on what that looks looks
16:29
like in our own
16:32
world asking for what we need can lead
16:34
to powerful conversations as I was
16:37
saying earlier you know our healthc care
16:39
provider might not know if things have
16:40
changed in our life and by communicating
16:43
to that to them we can start to open the
16:46
door to a different conversation of how
16:48
do I make this work right I hear what
16:51
you're saying and we'll talk about this
16:52
a little bit more in a few minutes but I
16:55
hear what you're saying and these are my
16:57
concerns about what that looks like in
16:59
my life right how can we figure this out
17:09
together I think it's always worth um
17:12
shining a light on
17:15
that these conversations can either
17:18
Empower us to speak up more or they can
17:20
push us back into um feeling a little
17:23
bit hopeless and sometimes it's not just
17:27
speaking up for our needs are speaking
17:29
up with questions about how does this
17:31
fit into my particular circumstance but
17:34
also letting providers know if something
17:36
that they've said is leaving us feeling
17:39
um less inclined to share more um and
17:43
that can feel like a really difficult
17:44
thing to approach and and a little bit
17:47
later today we'll spend some time
17:49
talking about how to approach that
17:51
conversation it is important to do it
17:53
because if we're feeling judged if we
17:55
are feeling stigmatized if we're feeling
17:57
unheard
17:59
um these are the barriers that we want
18:01
to break through so that we can be um
18:05
part of that system that is person
18:07
centered care right language does matter
18:10
um and sometimes someone who maybe
18:13
doesn't live with diabetes might not be
18:15
as aware of that and we have an
18:18
opportunity to inform them of that in
18:20
that moment um in a way that is going to
18:23
help us get the care that we need and
18:25
the care that we
18:27
deserve I think think it's also
18:29
important as patients to recognize on
18:31
that note that sometimes things might be
18:34
said um without ill intent with no sort
18:37
of malice behind it just that lack of
18:39
understanding lack of awareness of that
18:41
lived experience um that we talked about
18:44
earlier when we were talking about
18:46
stigma okay so how do we start these
18:49
conversations with our care team or our
18:51
health care
18:52
providers I think you know it's easier
18:55
said than done when there are those
18:58
power imbalances that we talked about or
19:00
when um we come into an appointment or
19:04
you know come into a meeting with our
19:06
healthare team um perhaps carrying some
19:09
of that stigma that may not even have
19:12
anything to do with our care team um you
19:15
know you see the examples on the screen
19:17
here and I'm going to just talk about a
19:19
few of them I think you know sharing our
19:22
intentions and clarifying our
19:25
expectations is always a good place to
19:27
start with healthy communic ation and so
19:30
I do recognize that this is important
19:33
you know I recognize the importance of
19:35
doing these particular things for my
19:37
health care and I also noticed that I'm
19:40
having a hard time making this fit in my
19:42
life at this point in time right so I'll
19:45
go back to the example from earlier
19:47
today around you know a single parent
19:51
who might let their blood sugars run at
19:54
a different level than is recommended
19:56
overnight right because perhaps worried
19:59
about how that might impact their their
20:01
young children um if they were you know
20:04
needed and they're prone to low blood
20:06
sugars overnight or when they drop they
20:08
drop significantly and they drop quickly
20:11
and so communicating I recognize the
20:14
importance of having my blood sugars in
20:16
this range and I'm really um you know
20:19
having a hard time making that work when
20:22
I don't have someone else there to care
20:23
for my children in the night if I have a
20:26
really bad loow and so sharing that with
20:29
um authenticity with
20:31
honesty um you know again that might
20:33
also just look like I'm really worried
20:36
about this blood sugar range or having
20:40
my um Target overnight being this value
20:44
because of these
20:46
reasons other ways um might just be
20:49
approaching with curiosity right is
20:51
there another way to do this when I'm
20:53
not feeling comfortable right these are
20:55
the ways or these are the reasons why I
20:57
don't feel comfortable right is there
20:59
flexibility in how we could approach the
21:02
school and perhaps the the most
21:05
difficult one and arguably maybe one of
21:07
the most important is if we are feeling
21:10
judged or we're feeling blamed for
21:13
aspects of our care not going the way
21:14
that you know most likely we all are
21:16
hoping for is communicating that and
21:20
really just clarifying our understanding
21:22
that this most likely was not the
21:24
intention right I know that this um
21:27
probably wasn't what you meant
21:29
and I also know that in this moment I
21:31
feel like I'm you know being to I'm
21:33
being blamed here or I'm really noticing
21:35
that I'm feeling like I want to pull
21:37
back um for these reasons those are most
21:41
often the hardest and the most important
21:43
conversations to have so that we can
21:46
reconnect with our Healthcare team and
21:48
they know where where we're at um in
21:51
some of these conversations as well I
21:53
think at the end of the day it is
21:55
important for everyone in this space to
21:57
hear that you are allowed to say these
21:59
things you are allowed to speak up as
22:00
the expert in your own experience and
22:04
maybe that doesn't always mean that
22:05
things change and the recommendations
22:07
that are provided it just gives a space
22:10
and a platform for everyone to be on the
22:11
same page about where you're at and what
22:14
makes sense for you as a unique person
22:17
living with
22:18
diabetes again linking this back to you
22:21
know where does this fit in the mental
22:22
health
22:24
conversation when we don't feel heard
22:27
when we feel judged when we feel like we
22:29
can't speak up when we feel scared or
22:32
worried or fearful about some of these
22:35
recommendations all of these things are
22:37
going to impact our day-to-day
22:39
relationship with ourselves um and I'll
22:43
reiterate one more time that can lead to
22:45
anxiety or feeling anxious going into
22:48
appointments that can lead to increased
22:51
feelings of
22:52
isolation that can lead to increased
22:55
feelings of Shame if we're leaving an
22:57
appointment feeling to blame
22:59
without a conversation about it and all
23:01
of these things have significant impact
23:03
on our mental
23:09
health some other strategies that can be
23:12
helpful when we are advocating for
23:14
ourselves is having someone come with us
23:17
to our appointments um who might be able
23:20
to kind of further the conversation if
23:23
we are feeling stuck or who might know
23:25
that we're a little bit nervous going
23:27
into the appointment and that we might
23:29
not
23:30
communicate um things in the ways that
23:33
we hope or we might feel a little bit
23:35
nervous about speaking up um because of
23:38
some of those power imbalances that we
23:40
talked about and so having someone come
23:42
with you um can be a really helpful
23:44
strategy just to navigate
23:46
that writing down your questions and
23:49
concerns ahead of time I think most of
23:50
us have probably been in a a situation
23:54
where we have lots that we want to ask
23:56
and then we get in the groove of the
23:58
appointment um or maybe some of that
24:01
those um again stigmas or that sense of
24:04
shame or self-blame come up um and we
24:08
feel like we don't have the right to ask
24:10
or the right the right to speak up um
24:13
and so we kind of lose our script and so
24:15
writing those questions down ahead of
24:17
time can help us stay on track with the
24:19
things that we really want to make sure
24:22
um we putting forward in some of those
24:25
appointments and then also asking for a
24:27
record of the plan that was discussed in
24:30
that appointment um a lot of times so
24:33
much is discussed that we might forget
24:35
things um or there can be a fear that um
24:39
if we have to meet with somebody
24:41
different the next time that that plan
24:42
or that discussion about some
24:44
flexibility to meet the same goal that
24:46
fits for us as a unique individual um
24:50
won't be heard the next time and so if
24:53
we can ask for a record of that plan
24:55
that keeps everybody on the same page
24:57
even if some members of our care team
24:59
are changing along the
25:05
way at the end of the day as a person
25:07
living with diabetes your perspective
25:10
and your voice matter um you are a part
25:13
of the team you offer an expertise that
25:17
nobody else has and that is your own
25:19
knowledge of yourself as a as an
25:21
individual um that is your knowledge of
25:24
what works for you um and what makes
25:26
sense or what fits in the context of
25:29
your life and your
25:31
circumstances and it is your right to
25:33
speak up to let others know what that
25:36
looks like
25:38
right our health care providers and our
25:41
care team they might just need our help
25:42
to understand what our concerns are or
25:45
what some of those circumstances are
25:47
that might mean that you know perhaps we
25:49
don't have the finances to eat fruits
25:52
and vegetables at every single meal
25:53
fresh produce at every single meal um
25:56
and they might not know that without us
25:58
sharing that that might mean you know
26:01
letting them know that our support
26:03
system has its limitations at times and
26:06
how do we work with that right if we're
26:08
the person really um kind of doing this
26:10
on our own or that might mean um you
26:15
know for athletes again right how how
26:18
does my body feel if I'm trying to go
26:21
into this sporting event at this
26:24
particular blood sugar versus this
26:25
particular blood sugar right and so
26:29
coming at it from the the lens of simply
26:33
just that our Healthcare Providers do
26:35
need our help to understand um what that
26:38
experience is like for us and you know
26:40
not going into it expecting that they
26:43
know um but rather going into it
26:45
expecting that they don't know and
26:46
seeing it as an
26:48
opportunity and at the end of the day I
26:51
think you know really anchoring into
26:54
this understanding that research and
26:57
best practices is and our lived
27:00
experience as an individual living with
27:03
diabetes that person centered care
27:05
framework they really can work together
27:08
and these are the ways that they can and
27:10
it is important that they work together
27:12
for our mental health as we navigate
27:16
living with diabetes
May 2024 – Mental Health Series
Unpacking diabetes distress and depression
Speaker: Dr. Gaurav Mehta, MBBS, MSc, FPCPC
Diabetes distress and depression may look and feel similar, but knowing how they are different will help you get the right care. Join us as we explore diabetes distress and how it is different from depression, tools used to make a diagnosis, and strategies that can help with managing your mental health.
Confident conversations: Getting the best health care for you
Speaker: Cassandra Millen, MSW
Talking about your diabetes care with your support team can be challenging, especially when stigma can get in the way. In this session, we provide strategies for engaging with your health care team and others who support your management to ensure your needs are met.
Diabetes is a family affair
Speaker: Lubna Aslam
The immediate impact of diabetes on a family can be overwhelming. What about the impact of generations within a family who have lived with diabetes? How do the beliefs, knowledge and attitudes of previous generations affect someone’s ability to cope with diabetes in the present? In this session we will shine a light on the generational influence on thriving with diabetes in today’s complex and ever-changing world.
Coming Fall 2024 – How to use the Clinical Practice Guidelines for your diabetes management series
These webinars are for educational purposes only. The content discussed in the webinars is not intended to be medical advice and, to the extent that medical advice is required, you should consult with a qualified medical professional. The information discussed in the webinars cannot replace consultations with a qualified health-care professional to meet your individual medical needs.
The views and opinions expressed in these webinars are those of the speakers and do not necessarily reflect the views or positions of Diabetes Canada.
The mental health video series is supported by an unrestricted educational grant from Sanofi.
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Missed our Nutrition Series?
Topics include: Basics of Healthy Eating, Eat Well, Spend Less, Popular Diets and Healthy Food Relationships.