If you have diabetes and you’re looking to better manage the foods you eat around the holidays, there’s some good news. It’s possible to stay healthy and still enjoy holiday indulgences, so long as you plan carefully and mind your portions.
There are a few reasons why managing diabetes around the holidays can get tricky.
[SEE: Healthy Holiday Snacks.]
Holiday Challenges for People With Diabetes
— There are a lot of tasty but sugar- and carb-filled foods. “Many traditional holiday foods are rich in refined carbs, added sugars and unhealthy fats, which can make blood sugar management difficult,” says Grace Derocha, a registered dietitian and Detroit-based national spokesperson for the Academy of Nutrition and Dietetics.
— It’s easier to overeat with so many yummy options. Plus, there are more gatherings where tempting food is available.
— You may feel social pressure. “Come on, just try a piece!” your friends and family may say. It could lead you to have too much of items that could spin your blood sugar out of control.
— You may be emotionally eating more. “Holidays can bring stress, loneliness or other emotions that lead to overeating or choosing comfort foods,” Derocha says.
If you’re not careful, those changes to your healthier routines can turn into real health hazards, including hypoglycemia, which involves low blood sugar levels, and hyperglycemia, or high blood sugar levels. Hyperglycemia can happen if you’re on insulin and not using enough or if you’re not using your diabetes medications as prescribed.
Another potential health consequence is a life-threatening emergency called diabetic ketoacidosis. This can occur if your body doesn’t have enough insulin to permit blood sugar into your cells to use for energy. Diabetic ketoacidosis can happen if hyperglycemia is left untreated, and it tends to be more common in people with Type 1 diabetes. Diabetic ketoacidosis can lead to what’s called a diabetic coma or even death.
Some research has also suggested that people with diabetes are more likely to have serious complications from COVID-19, such as blood clots. Spending more time socializing with others could raise your risk for exposure to COVID-19 as well other illnesses, including the flu.
Your 7-Step Diabetes Holiday Eating Game Plan
Here’s what to eat and where to be more cautious as you get closer to the holidays.
1. Know which foods to avoid
2. Focus on portion control
3. Enjoy protein-packed holiday dishes
4. Add veggie dishes to the menu
5. Rethink starchy foods
6. Consider modifying dessert recipes
7. Think about your drinks
1. Know which foods to avoid
Spoiler alert: You don’t really have to avoid any specific foods around the holidays, even when you have diabetes. Yet you have to be strategic about it.
“While some foods like sugary desserts may quickly raise blood glucose, you can still enjoy a small piece of them with a balanced meal to minimize the effect on your body,” says Vandana Sheth, a registered dietitian nutritionist and a spokesperson for the Association of Diabetes Care & Education Specialists.
That said, there are certain types of foods you’ll want to limit, to avoid a blood sugar spike:
— Alcoholic beverages
— Sugar-rich desserts
— Drinks with added sugars
— Refined carbs (think white rice, sugary sweet potato dishes and pasta made with white flour)
2. Focus on portion control
Portion control can go a long way in making holiday meals manageable when you have diabetes. Here’s a trick that dietitians often recommend: Fill your plate with one-third protein (like chicken or turkey), one-third veggies and one-third with a starchier item like mashed potatoes or a roll.
“This way, you can eat what you love without overdoing it,” says Erin Palinski-Wade, a Sparta, New Jersey-based registered dietitian and author of “2 Day Diabetes Diet.”
Before you go for seconds, wait a few minutes. Ask yourself if you’re truly hungry.
[SEE: 6 Portion Control Tips.]
3. Enjoy protein-packed holiday dishes
If you fill up on learn protein, like turkey, chicken or fish, you’ll satisfy your hunger without spiraling your blood sugar.
Aim for baked or grilled options instead of fried versions of your favorite protein dishes.
If you don’t eat meat, some other healthy protein options include:
— Beans
— Cottage cheese
— Lentils
— Nuts
— Unsweetened Greek yogurt
4. Add veggie dishes to the menu
Fortunately, there’s a lot you can do to make veggies part of your meals during the holidays. Here are a few suggestions for non-starchy veggie options:
— Green beans
— Leafy green salads
— Roasted Brussels sprouts or sweet potatoes
— Winter squashes
Make sure to work in dark, leafy greens as you plan any meals, Palinski-Wade advises. These are often forgotten during the holidays, but they’re a much-appreciated nutritional powerhouse this time of year.
5. Rethink starchy foods
Tempting traditional holiday foods like mashed potatoes and rolls with butter can be hard to resist but are filled with refined carbs and sometimes added sugar. If you balance out your plate with lean protein and vegetables, it’s usually okay to add a starchy favorite, so long as the portion size is smaller than or equal to your protein and veggie serving.
You also can look for healthier version of classic recipes, such as quinoa stuffing instead of traditional stuffing or cauliflower mashed potatoes instead of regular mashed potatoes. Look for recipes that use whole grains or whole wheat instead of refined white flour.
Also, mind your servings of foods with sauces and dressings.
“These can be hidden sources of sugar and carbs,” Derocha says.
Aim for homemade versions with less sugar or sugar substitutes.
6. Consider modifying dessert recipes
Yes, you can still have a dessert during the holidays when you have diabetes. Here are a few ways to make your desserts healthier:
— Use prunes to sweeten desserts. They’re naturally sweet, and they provide fiber. When baking, you can use pureed prunes instead of sugar in a 1-to-1 ratio, Palinski-Wade says. “This swap allows the dessert to taste just as sweet and moist without the added sugar and with a boost of nutrition and fiber,” she explains.
— Use no- or low-calorie sweeteners to replace sugar in your favorite dessert recipes. There are plenty of alternatives to regular sugar that can taste great in recipes.
— Enjoy smaller portions of desserts filled with refined sugars and fats, like pecan pie, cookies, fudge and candy. Instead of putting an entire piece on your plate, take a small bite.
— Try healthier dessert ideas, like baked apples or pears, dark chocolate-dipped strawberries or chia seed pudding with berries. Some recipes from Palinski-Wade include apple crisp sticks and keto chocolate cake.
7. Think about your drinks
Loading up on liquid calories is a surefire way to overindulge when the drinks are filled with alcohol or sugar.
Here are a few holiday drink ideas that will feel like an indulgence, even if they’re on the healthier side:
— Mocktails that use 100% fruit juice or sparkling water (such as Palinski-Wade’s hot toddy mocktail)
— Mulled spiced tea
— Sparkling water with slices of citrus fruit or berries
— Sugar-free hot chocolate
— Unsweetened herbal tea like peppermint or chamomile
Limit alcoholic drinks to a small serving without any sweetener. Or, choose a wine spritzer or light beer.
Diabetes-Friendly Holiday Snacks and Meal Ideas
Eating healthy with diabetes includes a balance of protein, fiber and healthy carbs and fats. When eating carbs, having these other food components helps to slow digestion and keep your blood sugar level stable, Derocha says.
Here are a few ideas for snacks that help balance carbs, protein and healthy fats:
— A whole-wheat pita with hummus, tomatoes and cucumbers
— Half a sandwich with a 2 to 3-ounce serving of tuna and lettuce and tomato
— One-fourth cup of nuts with a tennis-ball sized fruit, such as an apple or orange
— A few whole-grain crackers with a soft cheese, such as ricotta, and a few slices of tomato
— A pear with ricotta cheese and a small amount of maple syrup on top
— A red berry or green smoothie with Greek yogurt or tofu for protein
You can make your meal choices more balanced as well with these diabetes-friendly choices:
— A frittata or a crustless quiche
— A soup or stew with vegetables, beans and lean protein
— A casserole with protein, veggies and whole grains
— A heart-healthy fish, such as salmon or halibut, with vegetables and quinoa
— Cauliflower stuffing
— Crustless pumpkin pie
— Mashed potatoes with half-mashed cauliflower
— Vegetarian mushroom gravy
Additional Tips for a Healthier Holiday With Diabetes
In addition to these food tips, there are ways you can improve the holidays when you have diabetes. Here are a few healthy holiday tips:
— Plan ahead.
— Don’t skimp on exercise.
— Don’t “bank” your carbs.
— Travel smart with diabetes.
— Take stress-busting breaks.
— Monitor for symptoms of low or high blood sugar.
Plan ahead
Here are a few examples of when to plan ahead so you can stay on track with healthy habits:
— Plan when you’ll eat. Having a meal schedule can be helpful to manage blood sugar levels, says Amy Kimberlain, a registered dietitian nutritionist and certified diabetes care and education specialist based in Miami. If you know you’re going to eat later than normal, for example, plan ahead to have a snack around your normal meal time to help keep your blood sugar levels on track.
— Plan how many and which celebrations you’ll attend. This can help you manage stress, which can also raise your blood sugar. If you can stick to attending celebrations you truly want to attend, that means you’ll likely stress less.
— Plan what you’ll eat. When you plan ahead, you’ll know what fun foods you can enjoy without feeling like you might be overloading on carbs and sugar. If possible, find out in advance what’s on the menu of any special events. Pick an item you can indulge in with a small portion, and round out the rest of your choices with healthier foods. Consider bringing a dish if you know there will be something that you enjoy — and that others will like, too.
With all that planning, don’t forget to plan to enjoy your food.
“I try to remind clients that any food can fit, it’s a matter of how much and how often,” Derocha says.
Don’t skimp on exercise
Between cookie-baking sessions, big dinners and other special occasions, it’s easy to avoid physical activity during the holidays. Don’t! Here’s why: Physical activity offers so many benefits, especially during the holidays, including:
— Preventing weight gain
— Controlling your stress level
— Reducing stress hormones
— Improving your body’s ability to recognize and use insulin
If you find yourself pressed for time, do what you can, even if it’s less than usual.
“Doing something is better than doing nothing,” Derocha says.
That could mean 10-minute brisk walks after each meal, moving more as you clean up your house or decorate or finding ways to work in more steps while shopping. For instance, park your car farther away from a store entrance or take an extra lap or two around the perimeter of the mall.
Don’t “bank” your carbs
Controlling your blood sugar involves carb control. This includes distributing your carb consumption as evenly as you can throughout meals and snacks and sticking to healthy carbs, such as whole grains. It may sound like a good idea to have, say, 15 grams of carbs at breakfast time to save 105 grams for a holiday dinner. However, your body and your blood sugar work a lot more efficiently when you keep your carb count consistent with every meal, Derocha says. Having too many carbs at once can make it a challenge to keep your blood sugar levels stable.
Plus, banking your carbs or calories may make it more likely that you’ll get hungry and overeat, says Robert Alesiani, a clinical pharmacist for Tabula Rasa HealthCare in Moorestown, New Jersey.
Travel smart with diabetes
Traveling has become crazier than ever, and the last thing you want to worry about is whether you have enough of your medications or if your blood sugar will spike and affect your health when you’re not home.
Here are a few ways you can travel smarter during the holidays when you have diabetes:
— Pack and carry your medications as you would your finest jewelry, Alesiani advises. Don’t allow it to be crushed or mishandled. “Working in pharmacy for 35-plus years, I’ve had people walk in who need medications that were lost, forgotten or damaged,” he says.
— Have clear, up-to-date notes of your current prescriptions.
— Pack healthy snacks to take with you.
— If flying, bring any diabetes supplies, such as a blood glucose meter, on board with you versus packing it in checked luggage.
— Bring a water bottle that you can refill so you stay hydrated.
Take stress-busting breaks
Even with all the fun, the holidays can be stressful. As mentioned, getting too stressed can increase your blood sugar and just make you feel bad. Find ways to relax, whether through a walk, meditating, a nice bath or anything you do that gives you a healthy, stress-busting outlet, Kimberlain advises.
Monitor for symptoms of low or high blood sugar
Keeping any eye out for signs of low or high blood sugar can help you avoid any associated health risks. Even a small health issue can become a challenge during the holidays.
If your blood sugar is high, plan to do some physical activity, such as taking a walk for a few minutes; exercising may help lower blood sugar. After that, you can check your blood sugar again to see if it’s still high. Ask your health care provider in advance what else you should do if you have high blood sugar. Your provider may want you to change your medications or take a closer look at what you regularly eat.
A visit to the emergency room may be in order if you are confused, have shortness of breath, are vomiting, have ketones in your urine or if your blood sugar is 300 mg/dL or higher. Ketones are types of acids the body makes when it breaks down fat for energy. This could indicate diabetic ketoacidosis, the medical emergency that could lead to a diabetic coma. Your health care provider can advise if you should have a urine dipstick test at home to check for ketones.
Enjoying a Healthy Holiday
With some good planning and trying to stick to your routine as much as possible, you can enjoy a wide variety of holiday foods when you have diabetes. If you can slow down and enjoy your food, you’ll realize more easily when you’re actually full. Try setting your fork down between bites to slow yourself down. In addition, focus on people, not food.
“Keep the focus on connections, and prioritize conversations and spending time with loved ones,” Sheth recommends.
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Healthy Holiday Tips for People With Diabetes originally appeared on usnews.com
Update 11/22/24: This story was previously published at an earlier date and has been updated with new information.