Holidays can be stressful for those living with diabetes. In general, most people want to prepare their family favorites so they can be a special part of holiday celebrations. However, the social and dietary implications of holiday eating can make clients with diabetes feel uncomfortable and left out of the fun.
When working with patients with diabetes, try to put yourself in their shoes. Imagine a lifetime of eating whatever you wanted until the day you were diagnosed with diabetes. To make matters more difficult, the holidays come with a seemingly endless supply of high-fat, high-sugar, high-salt options: cookies and cakes at work parties; ham; turkey; stuffing; mac and cheese; lasagna; mashed potatoes; sweet potatoes soaked in brown sugar, butter, and marshmallows; and pumpkin and pecan pies. This smorgasbord can be a huge source of anxiety for people with diabetes, who must balance their desire to eat with their fear of high blood sugar if they do.
Hosts often try to accommodate guests with diabetes by serving items such as fruit and sugar-free pies and cookies adjacent to what they usually feature. These diabetes-friendly treats often taste terrible and usually have just as much carbohydrate or fat as typical desserts. Even if a person with diabetes felt OK skipping dessert, they might feel obligated to eat the special sugar-free treat since it was bought just for them. Furthermore, hosts often make their relatives or friends with diabetes take home all the sugar-free desserts, so what are they supposed to do to survive the holidays?
The following are tips to share with patients that can help them manage the season more easily:
• When there are no parties or events scheduled, encourage patients to prepare healthful meals and snacks so the month isn’t consumed with mostly poor choices.
• Since there are always more cookies and candy around this time of year, suggest clients eat smaller meals throughout the day to help them to control their appetites. Have them keep healthful, delicious snacks at home and work to make it easier to pass up unhealthful treats.
• If clients do keep cookies and other treats in the house, suggest they store them where they can’t be seen—out of sight, out of mind.
• Remind patients not to skip breakfast and lunch because they’re planning on eating a large meal later. If they’re starving when they go to parties, they’re going to overeat.
• Tell clients they don’t need to deprive themselves of favorite foods and snacks and that you can help them plan their meals so they can enjoy the holidays. If they really want something that isn’t healthful for them, remind them that a small portion is OK. If they want more than one serving, suggest they take another small portion home to have the next day instead of eating two portions at once.
• Recommend clients encourage hosts to include more healthful options at the gathering. Or, they can offer to contribute to the menu by bringing some healthful choices with them. They also can reduce their intake of calorie-dense foods by mixing them with more healthful selections. For example, they can add steamed broccoli to mac and cheese or make stuffing with nonstarchy veggies and low-sodium chicken broth to reduce fat.
• Suggest patients review all of the foods being served at a party to determine what they want to eat the most. This will prevent them from piling their plates with food as they pass around the platters at the dinner table. Only one quarter to one third of the plate should be starch or fruit; the rest of the plate should comprise veggies and lean protein. In addition, advise clients to stick to one serving of sweets if they choose to eat dessert.
• If clients take home leftovers, recommend they portion them into single servings and freeze them right away. This helps reduce late night eating and overeating in general. They can cut individual slices of desserts or take a single scoop of a casserole or other dish and place each single serving onto a baking sheet covered with wax paper. Then, they can freeze the servings until solid, wrap each serving in plastic wrap, and store in a resealable freezer bag, marking each bag.
• Encourage patients to engage in family holiday traditions that aren’t just about food, or start new, healthful traditions. They can play outdoor games, take walks, go ice skating, look at family albums, and play musical instruments.
• Patients often change how they take their medications when traveling or attending parties so encourage them to take their medications as prescribed unless they’ve discussed a change or new plan of action with their doctors. In addition, suggest they check their blood sugar levels as usual.
• Let patients know that alcohol can cause dehydration and low blood sugar or high blood sugar if it’s mixed with high-carbohydrate flavorings or beverages.
• Encourage patients to stay hydrated by drinking water throughout the day and maintain any prescribed fluid restrictions.
During this festive season, it’s important to remind clients that if they stray from their eating plan for one day, it’s only one day. They shouldn’t adopt the mindset that since they blew their diet now it’s OK to continually eat everything. Encourage them to get back on track as soon as possible.
— Marlisa Brown, MS, RD, CDE, CDN, is an award-winning dietitian, chef, and public speaker. She’s president of Total Wellness, a private nutrition consulting company specializing in diabetes, CVD, gastrointestinal disorders, gluten-free diets, culinary programs, corporate wellness, and medical nutrition therapies, in Bayshore, New York, and is author of Gluten-Free, Hassle Free and Easy Gluten-Free. Marlisa blogs at http://marlisaspeaks.com/marlisas-blog and www.GlutenFreeEZ.com.