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Be Ready and Plan for Challenges

“This season is full of special events, from office potlucks, to baking cookies with the kids, to formal dinners in fancy restaurants. Take inventory of all of your upcoming obligations and holiday events, and what challenges might come up at each one.

Decide in advance which of these events is worthy of indulging (I know that I’d rather treat myself at certain events than others) and think of ways to manage some of the challenges you anticipate. Being prepared for challenging situations will make it easier to stay on track.”

–Jill Weisenberger, MS, RDN, CDE, CHWC, FAND, author of Prediabetes: A Complete Guide. Find her on the web at jillweisenberger.com

Eat Breakfast!

“It may be tempting to skip your morning meal in order to plan for a festive meal later in the day. However, skipping breakfast can leave you feeling over-hungry at meal time, which leads to over-eating. This may more than make up for the calories you skipped in the morning. And, more importantly, skipping meals can lead to extreme highs and lows in your blood sugar, including a blood sugar spike after that festive meal.

To prevent cravings and overeating later in the day, start your day with something light, like this Herbed Soft Scrambled Eggs on Toast.”

–Jackie Newgent, RDN, CDN, author of the forthcoming The Clean & Simple Diabetes Cookbook. Find her on the web at jackienewgent.com 

Be Physically Active

“With all the food being served during the holidays, many people forget to move around. Start a new tradition that involves physical activity away from the food. For example, before Thanksgiving many towns hold a “turkey trot”—a race or long walk that usually takes place on Thursday morning.

You can get the whole family and even the neighbors involved in activities like a friendly game of touch football, soccer, or Frisbee. It can also be as simple as a family walk around the neighborhood.”

–Toby Amidor, MS, RD, CDN, FAND, author of the forthcoming The Create-Your-Plate Diabetes Cookbook. Find her on the web at tobyamidornutrition.com 

Gather Information

“Managing diabetes is a constant learning process, and there is plenty you can learn over the holidays! Tracking information will help you understand how your body responds to different factors. Food journals, exercise logs, blood glucose records, and medication monitoring are all important aspects of managing diabetes. Gathering this information will give both you and your healthcare providers the tools needed to adapt and adjust your diabetes care plan to achieve success.”

–Lori Zanini, RD, CDE, creator of www.ForTheLoveOfDiabetes.com 

Don’t Beat Yourself Up

“The holidays are a hard time for anyone to stick to healthy habits, and it can be especially challenging if you’re learning to manage a new diabetes diagnosis. Some days will be better than others—the important thing is to not beat yourself up for going off your meal plan one day. You can always get back on track the day after the holiday gathering. And don’t forget to give yourself credit for what you’re doing well!”

–Shelby Kinnaird, creator of www.diabeticfoodie.com

Take Something Healthy to Share

“If you are concerned that the food at a holiday gathering won’t fit your meal plan, then consider bringing a healthier dish to share that suits your preferences and needs. That way you’ll know there’s at least one item you can enjoy without worry. And chances are your host will welcome an addition to the party spread.

You can browse Diabetes Food Hub to find diabetes-friendly recipes for appetizers, snacks, and entertaining.”

–Tami Ross, RD, LD, CDE, MLDE, author of What Do I Eat Now? Find her on the web at www.tamirossrd.com 

Be a Picky Eater

“The typical holiday feast is usually pretty abundant in carb-rich choices, which can leave you with too much on your plate. Pick and choose only what you really love, or what is special this time of year. For example, the Thanksgiving table can include a lot of high-carb choices—mashed potatoes, sweet potatoes, stuffing, corn, rolls, pie. Let yourself indulge in the foods that are most special, and skip the rest.”

–Katie Morford, MS, RD, creator of www.momskitchenhandbook.com 

Drink Responsibly

“The holidays are a time to be together with friends and family, and that will usually involve alcohol. While a moderate amount of alcohol (1–2 drinks per day) is perfectly fine for people with diabetes, be careful of overindulging and be aware of safety concerns while drinking with diabetes. For example, drinking can increase your risk of hypoglycemia.

Alcoholic drinks can also add a lot of calories and carbs to your meal. Choose drinks that are naturally lower in calories and don’t have added sugars. For example, a glass of wine only has only 4 grams of carbohydrate and about 120 calories, while a regular margarita can have up to 30 grams of carbs and around 230 calories!

–Marina Chaparro, MPH, RD, CDE, founder of nutrichicos.com 

Enlist Support

“Identify at least one person that you can rely on for support and accountability throughout the holiday season. It can be a healthcare provider, spouse, family member, coworker, friend…anyone you trust. Share with them in advance how they can support you, check in on you, and help you meet your goals throughout your first holiday season living with diabetes.”

–Lori Zanini, RD, CDE, creator of www.ForTheLoveOfDiabetes.com 

Follow the Plate Method

“Finding the right balance can be tricky when faced with a large holiday spread, but use your (9-inch) plate to help guide your portions. First, fill half your plate with non-starchy vegetables like spinach, carrots, brussels sprouts, broccoli, etc. Now you have another half to customize. Fill one quarter of your plate with lean protein and leave the last quarter of your plate for carb foods, such as corn, breads, mashed potatoes, fruit, or dessert. This is an easy way to build a balanced plate without spending time counting carbs or having to pass up your favorite foods.”

–Shamera Robinson, MPH, RDE, CDE, Associate Director of Nutrition, American Diabetes Association

Our Relationship with Food

Food is important when it comes to keeping blood sugar in range, but managing diabetes is not just about glycemic control—we also need to juggle lifestyles, health goals, and mental health.

There are so many factors that influence our food choices, and you cannot see those factors by just glancing at a plate. Food is an important part of our lives, and it can have so many meanings to different people. It can mean health, love, sense of community, or pleasure, but for others, especially people with diabetes, it might cause feelings of anxiety and fear. 

Changing the way you eat is a major lifestyle change, and major lifestyle changes always take time.

While you are on this journey, unsolicited advice from strangers and even loved ones can feel more like judgment and might cause you to question yourself or feel guilty about your own choices.

Changing the way you eat is a major lifestyle change, and major lifestyle changes always take time. There are a lot of things to juggle when managing diabetes, so be patient with yourself and with others.

Unintended Consequences

Food shaming often happens when someone’s own preferences and opinions don’t line up with others’. Judgmental comments like “you shouldn’t eat that” may be a projection of their own frustrations or a reflection of their misconceptions about diabetes.

As clinicians who work with children, teens, and young adults with diabetes and obesity, we know that talking about food can be very difficult. We also know that negative comments, pictures, and memes on social media can have a harmful impact on someone’s emotional well-being, especially people with diabetes. 

No one should be shamed about their food choices.

No one should be shamed about their food choices. Shame leads to negative feelings about food, which can lead to anxiety, depression, and even disordered eating. And these conditions can cause more damage to physical health than poor diet.

Rethink the Role of Food and Your Health

Instead of thinking of food as “good” or “bad,” or judging people (or yourself) by the way you eat, picture food and eating as being neutral and adopt a non-judgmental way of thinking. The food you put on your plate, is just food that will provide energy and nutrients to fuel your body. 

Unlearning what we have been exposed to takes time but being aware of those negative thoughts is a start. 

Instead of thinking of food as “good” or “bad,” picture food and eating as being neutral.

Remind yourself that there is no one right way to eat with diabetes— it has to be tailored to your own unique needs— like your budget, taste preferences/favorite foods, cultural norms, cooking skill, time, etc. And you don’t have to feel guilty about enjoying a treat every now and then.

Break the cycle and be nice to yourself and to others. Instead of criticizing people, ask them how they feel about the changes they’ve made and have them decide how they feel about it. If appropriate, provide encouragement.

If you are concerned about a loved one, privately ask how they are doing, and don’t offer advice unless they ask for it. Ask if there is anything you can do to support them, and/or seek information about healthy food choices and incorporate this in your own life as a form of support for your loved one. 

If you feel this is a big issue in your own life, don’t be afraid to seek out help—talk to your primary doctor or with a therapist. If you don’t have a therapist ask for a referral from your doctor. To find a mental health provider with knowledge about diabetes, check this directory.

Bottom Line

Food is meant to be nourishment for our bodies and to be enjoyed; find a balance that works for your health, be confident in your choices, and be accepting of other people’s choices. 

If you find yourself wanting to criticize someone else’s food choices or appearance, don’t! This is generally not helpful and can have a negative emotional impact. 

A neutral and non-judgmental way of thinking is best when talking about food and diabetes; there are no “good” and “bad” foods. The key is to balance what you eat to get the nutrients you need. 

If you receive a negative comment from a stranger on social media or in person, remember that person doesn’t know you and how you take care of yourself. Don’t beat yourself up and continue to focus on ways to be the healthiest version of yourself. 

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Amy Riolo is author of The Mediterranean Diabetes Cookbook.You can order a copy of the new edition directly from the American Diabetes Association by clicking here. 

Getting Started with Meal Planning

When planning a Mediterranean menu, it’s important to consider the season, region, occasion, and personal traditions. According to the Mediterranean-style eating pattern, the largest portion of our daily diet should come from plant-based foods, with vegetables topping the list. Vegetables are at their peak flavor (and often cheaper) when they are in season and locally grown. As you start planning your meals for the week, find out what vegetables are in season or on sale at your local grocery store, and choose your recipes based on those vegetables. 

Nutrition Considerations

Throughout the Mediterranean region, a balanced meal is considered to contain carbohydrates, protein, and fats. The more healthful choices you make in those categories, the better your meal will be: whole grains and vegetables are ideal sources of carbohydrates; lean proteins such as fish and chicken are great protein choices; and nuts, olives, avocado, yogurt, and lean cheeses provide healthy fats. 

Recipes from the American Diabetes Association contain nutrition information, serving size, and exchanges/choices, so you know exactly what you’re putting on your table. It can be difficult to figure out exactly how much carb, protein, or fat you’ll get out of a homemade dish, which is where this information comes in handy.

There are several tools that can help people with diabetes plan meals such as exchanges/choices, the plate method, and carb counting. The best way to learn more about these tools is to meet with your registered dietitian or diabetes educator. And remember, where, when, and how you eat are also important components of the Mediterranean lifestyle.

Tips for Medtierranean-Style Meal Planning

Breakfast:

• Some people prefer to start the day with a quick, light breakfast, others prefer a hearty breakfast to keep them full until lunchtime. Consider your morning routine, blood glucose levels, and food preferences, and find a breakfast routine that works for you.
• If your mornings are hurried, keep plenty of low-fat yogurt, whole-grain cereal, part-skim cheese, nut mixes, and fresh fruit on hand for breakfast-on-the-go.
• Find recipes that you can prepare ahead of time for a homemade grab-and-go breakfast.

Lunch:

• One of the easiest ways to make lunch is to bring leftovers from the previous night’s meal. If you don’t like eating the same thing two days in a row, freeze individually portioned meals and defrost them for lunch as needed.
• Make large batches of salads and pack them in individual serving-size containers with dressing on the side to bring to work.
• For days when you can’t bring lunch, keep your own “menu” of tasty and healthy lunch options from nearby stores or cafes.

Dinner:

• Plan weekday dinners ahead of time (get the whole family involved!) and make sure you have everything on hand each night to stick to the plan. 
• When you have some extra time to spend in the kitchen, prepare extra meals for another day, or prep ingredients to cut down the cooking time on busy weeknights. 

One-Week Mediterranean Meal Plan

Here is a sample Mediterranean meal plan using recipes from The Mediterranean Diabetes Cookbook. The recipes contain a variety of cooked and raw vegetables for interesting texture and variety. Lean protein sources include salmon, turkey breast, lamb, and lentils. I’ve provided an example of how these recipes can be arranged in a weekly meal plan, using leftovers throughout the week to cut back on cooking and prep time. You can use these recipes to build your own meal plan using the Diabetes Food Hub meal planner: Save the recipes, then drag and drop them into the meal planner. Once you have everything in place, you can even generate a grocery list to make shopping easier.

For more help using the meal planner, check out this tutorial.

Breakfast:

• Moroccan Avocado Smoothie
• Mini Vegetable Frittata*

Lunch/Dinner:

• Moroccan Lentils with Stewed Tomatoes*
• Mixed Pepper Medley*
• Provencal-Style Herb-Roasted Turkey Breast*
• Chilled Tarragon and Tomato Soup*
• Salmon with Pea Puree
• Apple, Beet, and Carrot Slaw*
• Lamb, Kale, and Pomegranate Salad
• Orange, Asparagus, and Avocado Salad

Snacks/Dessert:

• Date, Almond, and Sesame Balls
• White Bean, Lemon, and Herbed Feta Dip
• ​Strawberry Mascarpone Parfaits

*These recipes are great to make ahead of time. Prepare them over the weekend or whenever you have some extra time for cooking, and portion them in individual serving containers for grab-and-go breakfast or lunch.

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