Diabetics: Keep carbs in line, especially at holidays


Michelle Bravo Johns Hopkins Diabetes Center

December 22, 2008|By Holly Selby | Holly Selby,Special to The Baltimore Sun

Candy canes, pumpkin pie, mashed potatoes, oh my. Holiday treats can wreak havoc on anyone's diet plan, but for the approximately 23.6 million Americans with diabetes who are trying to maintain good glucose control, the festive season can be particularly difficult to navigate.

Nonetheless, this doesn't mean that diabetics can't join in the festivities, says Michelle Bravo, a dietitian and certified diabetes educator at the Johns Hopkins Diabetes Center. There are steps that can be taken to help maintain good health.

What do you tell your patients about the holiday season?

I tell them not that there are certain foods offered during the holidays that they can't have because of diabetes, but that they need to have portion control. It is not about bad foods, it is about bad portions. Large portions of carbohydrates will drive blood sugars high.

What advice do you have as the holiday season hits full swing?

The three keys for success in controlling your blood sugar levels are planning, portion control and activity. If you try to stay consistent with those three things, you'll be on your way to success.

How should you begin planning?

Start ahead of time getting your blood sugar under control so you have a good baseline. Practice stress management - because the holidays can come with stress. Get exercise. Take your medications. Check your blood sugar.

Check your calendar and look at the days between Thanksgiving (or Christmas) and New Year's to see how many times you plan to be out at parties or restaurants. I coach my patients to think about the foods they were exposed to last year and decide what foods they want to use their "carb budget" on.

Controlling the "carbs" is the key. Meet with a diabetes instructor to get a plan so that you understand what carbs are - then you can enjoy the food. Or check with the American Diabetic Association for good tips about carbohydrates.

You mentioned activities. What is your advice about staying active during the holidays?

It is important to continue your exercise during the holidays, although it can be really hard to do. But [an exercise regimen] will reduce your stress, which is often higher during the holidays, and it can help reduce your appetite. Make an appointment with yourself to exercise. If you can do a little walking on the day of a party, it will help.

OK, so the big office party is tonight; are there steps to take before going?

I encourage people to eat something before going to a party so they don't arrive hungry. Have a small snack: lean protein, whole grain cereal with 1 percent milk, half a sandwich to curb the appetite.

You also can drink some water or noncaloric beverage before eating. A glass or two of water will help you have a feeling of fullness.

What if you arrive at the party and there is a buffet filled with your favorite foods?

At the time of the meal, assess the room to see what foods are there and think about what you should eat and how to balance your plate.

Fill your plate half full of nonstarchy vegetables like carrots, broccoli and salad. As you fill your plate, think small. Use the dessert plates instead of the big plates. That helps reduce the portions.

Think also about beverages: They are a big source of calories. Alternate that cup of eggnog or 12-ounce soda or fruit punch with water. Check with your physician about whether alcohol is safe for you to drink.

Don't sit or stand near the food table. Fix your plate and move to the next room. Talk and mingle while you eat so it slows you down.

What other steps should you take?

When we eat carbs it can affect the blood sugar levels in about two hours depending upon the fat content of the meal. Check your blood sugar level about two hours after the start of a meal.

What if you slip up? You skip your exercise and go to a party and eat far more than you should?

Just start back with the good habits the next day. ... Pick yourself back up - don't wait for the end of the holidays.

Holly Selby is a former reporter and editor for The Baltimore Sun.


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