By: Laurie Block, RDN, CDE
When I ask people what they are most thankful for during Thanksgiving, I get two answers: “My family” and “My health.”
Fortunately, when it comes to health you can have input and be an active participant. For the many years that I have been in practice, I have encouraged individuals and families to pull out their personal tools and preplan for occasions during the holiday season.
The importance of personal insight, decision making and problem-solving is important when there is so much involved: temptation, change in routine, emotions, and the pressure of maintaining traditions.
Keeping personal goals at the forefront is an incredible challenge especially with the demands of managing diabetes.
Here are some useful tips to keep in mind this Thanksgiving, so that you can truly focus on what’s important to you!
1. Keep in Mind Lean Protein
Traditionally, turkey is served at Thanksgiving, but even if you use other forms of protein, it’s important to know that most cuts of protein have negligible amounts of carbohydrates and range from 35- 100 calories per ounce.
The wide calorie range is because fat content varies in different cuts of meat and poultry. For Thanksgiving, keep in mind that white meat turkey has only 40 calories per ounce and is one of the leanest forms of protein. In addition, turkey has 0 grams of carbohydrates and has little effect on blood sugar levels.
It is an excellent focus for a healthy plate. Keep the portion ideally limited to 4-8 ounces to have room for appetizers, side dishes, and dessert.
If you are adding gravy the idea is to a “dress” the turkey; not drown it with gravy.
Check out the nutrition facts of different cuts of turkey here.
2. Choose Vegetables with Volume
Vegetables are low in carbohydrates and provide only 5 grams of carbohydrate and 25 calories per cup.
Using a low-fat cooking technique such as steaming or sautéing will assure that there are limited amounts of hidden fats.
Vegetables are an important part of a healthy plate and provide many of the behavioral components needed to develop a healthy meal.
The color, extra texture, fiber, and chewing factor will prove helpful to keep the meal low in carbohydrate and provide the visual satisfaction that is important during holiday meals.
3. Choose Grains and Starches with Fiber
Keep the grains that make it to your Thanksgiving table whole and keep them simple.
When it comes to grains, traditionally sweet or mashed potatoes are served along with a holiday meal.
If it is possible, keep your grains whole, even the potatoes! Serving a whole baked or sweet potato will indirectly help to prevent any added hidden fats. And, at least you will be able to see if you add a pat of butter.
From my experience, I would rather recommend a ½ baked or sweet potato rather than a serving of grains. It’s also easier to control the amount and provides the volume needed on a holiday plate. After all, many people are not likely to eat 2-3 baked or sweet potatoes but, they may find it really easy to take another spoonful of mashed potato, scoop of rice or quinoa.
In practice, I often see people eating too much “ brown rice” “ quinoa or whole wheat pasta. Even healthy grains and starches have carbohydrates and can quickly add up to excess calories and carbohydrates.
The most important thing to remember with grains or starches is portion control and how much you personally will eat. Most cooked grains have 15 grams carbohydrates, and 80 calories per 1/3- 1/2 cup.
Use visual cues such as a computer mouse for a baked potato or tennis ball for a grain. Consider avoiding grains completely if portion control is too difficult or if you have indulged in a high carbohydrate appetizer or are planning to eat dessert.
4. What to do About Alcohol?
If you have diabetes, alcohol is not necessarily off-limits. Speak to your health care team to be sure that alcohol can be part of your plan.
The American Diabetes Association (ADA) recommendation for alcohol is one alcoholic equivalent for women and 2 equivalents for men.
An alcohol equivalent is equal to 5-ounce red or white wine, 1 ounce distilled spirits such as vodka, or 12 ounces of beer.
Be sure to monitor your blood sugars and eat something while you drink to prevent low blood sugars.
Click here to find out more about recommendations for alcohol from the Center for Disease Control (CDC).
5. Apple, Pecan, Pumpkin or Skip the Pie Altogether?
Dessert is perhaps the biggest challenge for many living with diabetes. Ask yourself, “Is this something you really want, or is there another agenda as to why you are eating simple sugars?”
If you want a treat, by all means, incorporate a small piece of pie or dessert into the plan.
If needed, use your carbohydrate counting skills and take extra insulin as needed. When it comes to simple sugars this is a time to use personal insight.
Be sure you are not eating desert to prove a point or use a holiday as an excuse for eating refined carbs.
To understand more about the calorie and carbohydrate content of your desert try using an app such as Calorie King. Using an app may give you a ballpark figure of how many calories and carbohydrates are in your desert.
6. Sweet, Tart, Delightful, Cranberries
Cranberries are traditionally used as an accent for turkey but for the holidays they are really healthy to sprinkle on salads or can be made into a sauce as complement poultry and meats.
1 cup of whole cranberries has just 12 grams of carbohydrates and only 45 calories.
To learn more about how to prepare low carbohydrate recipes with cranberries check out this guide from the USDA website.
7. The Behavioral Component, Mindfulness and Exercise
It may sound trendy, but mindfulness and behavior are really important during the holidays. If you tend to snack or overeat here are some important reminders:
Drinking non-caloric fluids and hot beverages may be helpful before a meal. Try some hot herbal teas, decaf coffee, hot water with lemon, and even some low-calorie cranberry juice cocktail.
- Busy foods and Finger Foods
Low-calorie snacks that take a long time to eat can be very helpful during cocktail hour or when appetizers are being served.
Keep foods available that take a little extra work and a long time to eat. Pomegranates, edamame, walnuts in the shell, sunflower seeds, raw vegetables are all examples. These foods help you with the behavioral aspect of holiday dining.
Exercise pre or post-meal can provide significant benefits to blood sugar levels, and keep total calories in check.
Walking before or after a meal will help you remember you are sharing the holiday with family and friends in ways that do not center around food.
Even yoga and meditation before your family gathering can be helpful in keeping you focused on your health care goals.
- Remember to take your Medication
Carry your insulin and medication with you at all times. It may be important to take an extra bolus to help correct elevated blood sugars or to “cover” for extra carbohydrates at a meal. After all, sometimes we all need to indulge a little.
Remember to speak to your health care provider if you are traveling through different time zones to make sure you stay on track of your medication timings and that you have an adequate supply of medication before you embark on your journey.
Wishing you a healthy and safe holiday season!
Laurie Block RDN, CDE is a Registered Dietitian/Nutritionist who practices in New York City and La Jolla, Calif. She specializes in medical nutrition therapy with a special interest in diabetes, obesity, and cardiovascular risk factors. She is the author of the Type 1 Diabetes Cookbook published by Rockbridge Press and enjoys writing about nutrition-related topics. Block is passionate about helping kids, teens and adults reach their health care goals. She is involved in Marjorie’s Fund, a global initiative to empower adults living with Type 1 diabetes. She is also the co-founder of the Kids and Healthy Weight Program at New York-Presbyterian/Weill Cornell Medicine.
- U.S. Department of Agriculture. Nutrition Facts. (2011, November). Retrieved November 21, 2019, from https://www.fsis.usda.gov/shared/PDF/Chicken_Turkey_Nutrition_Facts.pdf
- U.S. Department of Agriculture. Green Beans. Retrieved November 21, 2019, from https://snaped.fns.usda.gov/seasonal-produce-guide/green-beans
- Center for Disease Control and Prevention. (2016, October 18). Fact Sheets – Moderate Drinking. Retrieved November 21, 2019, from https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm
- John Hopkins Medicine. Mixing Alcohol with Your Diabetes. Retrieved November 21, 2019, from https://www.hopkinsmedicine.org/gim/core_resources/patient%20handouts/handouts_may_2012/mixing%20alcohol%20with%20your%20diabetes.pdf
- Jones, Angus G., et. al. Diabetes Care. (2014, May). Effect of the Holiday Season in Patients With Diabetes: Glycemia and Lipids Increase Postholiday, but the Effect Is Small and Transient. Retrieved November 21, 2019 from https://care.diabetesjournals.org/content/37/5/e98