When we first heard about Maggie Smith's situation, it didn't seem as serious as some we've dealt with in The Sun's monthly Make Over My Meal series.
Boy, were we wrong.
The 32-year-old working mother of two does a good job of getting a meal on the table every night in spite of a lengthy commute from Owings Mills to her home in Frankford. Usually the family has dinner together, and everyone pretty much eats the same thing.
While 4-year-old Melina and 2-year-old Myles aren't great eaters, they enjoy some fruits; and Smith makes sure they drink lots of milk. The kids' parents are strict about sweets, and don't have them in the house except for jelly to make peanut-butter-and-jelly sandwiches.
Where Smith needed particular help was with her husband's diet.
Melvin, 38, had recently been diagnosed with type 2 diabetes. His doctor talked in general terms about what he should be eating, but hadn't referred him to a nutritionist.
Robin Spence, our makeover series guru and a registered dietitian at Union Memorial Hospital, felt Melvin could benefit from a consultation with a nutritionist who would design an individual meal plan with rationale for him. "[The dietitian] would take into account the physicality of his work, need for snacks and meals, and ideas for carrying food on the job site," she said.
Almost 21 million people in the United States have diabetes, according to the American Diabetes Association, but nearly a third of them don't know it. You could consider Melvin one of the lucky ones. He has a chance to do something about his disease by eating the right foods in the right amounts.
Maggie is the food shopper and cook, so some of the responsibility falls on her. It's hard because Melvin doesn't seem sick, although he's at greater risk for heart disease and other serious health problems because of his diabetes.
Maggie said. "I know the basics like no sugar and no fried foods, but sometimes I'll serve something and he'll say, 'I can't eat that.' "
Dinner is often carryout - pizza, perhaps, or chicken in a box. Takeout from a local Italian restaurant a few days before we visited the Smith home was spaghetti carbonara for him, shrimp and chicken over fettuccine for her and a Caesar salad. Their dinners tend to be heavy on meat and carbohydrates and light on fresh vegetables.
When Maggie does have time to cook, a typical meal might be baked chicken and rice with peas and corn, also carbohydrate-heavy. Although they don't eat much fish, Maggie says she does get salmon at BJ's Wholesale Club once a month, and the family will have it for a couple of meals.
"The big, big thing about me," Maggie said, "is I have not been good about vegetables."
There is some positive news. A healthful diet for diabetics is also a healthful diet for everyone in the family, including Maggie, who would like to lose a few pounds. It should include lean meats and fish in small portions, whole grains and lots of nonstarchy vegetables such as broccoli, spinach, carrots and green beans. "Good" fats (from plant sources and fish) should be used with moderation.
As Spence pointed out when we arrived at the Smith home with our makeover-meal ingredients, sugar isn't the only culprit for diabetics. Melvin is good about reading nutritional labels, but he didn't realize he should be keeping track of more than just sugar.
"Look for the total carbs," Spence said. Carbohydrates are changed into simple sugar called glucose during digestion. She also advised him to look for not only the word "sugar" in the list of ingredients, but anything ending in "ose," such as fructose - a way manufacturers disguise just how much sugar a food contains.
Although Melvin, an electrician, is usually home by 3 p.m., it's a given in the Smith household that he isn't going to cook. When pressed, he told Spence he might be willing to take something out of the fridge for Maggie to prepare when she got home. But chopping up some vegetables? No way. Maggie is the food provider. That means she either needs to prepare something in advance or have recipes that take little time. Otherwise, carryout is too tempting.
Given the time constraints, Spence had several suggestions for dinners that would be quick, easy and nutritious.
"You need shortcuts," she told the couple. A slow cooker would make sense for this family, and Maggie agreed to borrow her sister's and try it out. The nutritionist suggested having cans of juice-packed fruit on hand to add to emergency meals. A salad would be better, but canned fruit is better than a cheeseburger from Wendy's. Spence also gave the family a recipe for a basic broiled barbecued chicken from the American Diabetes Association publication Healthy Calendar Diabetic Cooking.
Although she was conscious of the need for speedy recipes, one thing Spence wanted to do was introduce the family to fresh herbs as an alternative to using salt and fat for flavor. She demonstrated how to cut the herbs with kitchen scissors to speed up the process.