Presentation on theme: "Controlling Diabetes During the Holidays Janine Freeman, RD,LD,CDE"— Presentation transcript:
1Controlling Diabetes During the Holidays Janine Freeman, RD,LD,CDE UGA Extension Nutrition Specialist
2‘Tis The Season For Temptation Out-of-control blood sugarsExtra poundsWith the holiday season upon us, there will bemore boxes of chocolate,sweet potato pies,and tempting cakes than you can count.And for the momentary pleasures they can give you, they can wreak havoc on blood sugar control.It can be a challenge to keep your diabetes well-controlled and keep off the unwanted pounds.
3Holidays Are A Time To: Share with family and loved ones Become spiritually connectedShop, decorate the house, wrap giftsBake and cookEat, eat, eat...(USE MOUSE)The holiday season should be a very special time set aside to share with family and loved ones.A time when many people become more spiritually connectedFamilies and friends partake of the season’s festivities.Unfortunately, holiday customs seem to primarily revolve around eating:-You meet friends for a holiday lunch.-You attend parties with loads of tempting foods and drinks.- You bake holiday treats.-Family get-togethers involve more food than anyone can possibly eat.
4Focus On Holiday Activities That Don’t Involve Food Decorating for the holidaysAttending holiday musicals or playsChristmas carolingShoppingGift-givingTry to focus on holiday activities that don’t involve food. WHAT CAN YOU DO?Have family or guests help decorate for the holiday;organize groups to attend holiday musicals or plays,have a caroling party.Go shopping(KEEP WITHIN BUDGET)with your family or friends even if you’re finished purchasing your gifts to get some extra activity and to enjoy the holiday spirit.Think of ways you and your family can participate in gift-giving, especially to those in need. (Retirement Centers, sponsor a family to give gifts through churches or other organizations)
5Make Time for Physical Activity Relieves your stressImproves your moodLowers your blood glucose levelsHelps with weight controlMake time for physical activity despite your busy schedule. It canrelieve your stress that’s so common during the holidays,improve your mood, making you more likely to keep up with your self- care responsibilitieslowers your blood glucose levels,and help with weight control.
6Fit Physical Activity Into Your Busy Schedule Split your activity into 2 or 3 intervals of minutes eachMake physical activity a family eventWalk around the neighborhood after dinnerGo mall-walkingPark farther from your destinationThink you don’t have a 30-minute block of time to walk? Try splitting it up into 2 or 3 segments of minutes each. Maybe once in the morning, after lunch, and after dinner. It’s easier to fit into your schedule.Gather your family together and make physical activity a family event. Children learn by example. Make physical activity part of the family routine. You can catch up on what’s going on with your family during the walk.In inclement weather, go mall-walking. Many malls have walking clubs.When shopping, park as far away from the store as you can to get in extra steps.
7Stay Active While Travelling Wear walking shoesGet to airport early and walk concoursesTake very little carry-on luggage and walk during layoversLook for hotels with exercise facilitiesAir travel can interfere with exercise routines. Be creative as to how you can incorporate some physical activity. It’s also very important to get up and move around during long flights.
8Lighten Up Your Favorite Holiday Foods Make changes in recipes to:lower the carbohydrateless effect on blood glucoselower the fat or change the type of fathealthier for your heartfewer caloriesYou can still eat traditional holiday foods like everyone else. However, you can make some changes to either reduce the carbohydrate in high-carbohydrate foods and/or lower the fat in traditionally high-fat foods.
9Holiday Baking Desserts can be made with: sugar low-calorie sweeteners Many desserts can be made with either sugar or low-calorie sweeteners. Some, however, work best with sugar.If you use sugar, you’ll get additional carbohydrate - the amount will depend on how much sugar the recipe calls for.
10Use of Sugar in Diabetes Meal Plan Raises blood glucose levels in similar way to starchesCan be used in moderationYears ago experts assumed that foods with sugar made the blood sugar increase more quickly and to a greater extent than starchy foods.Research now has shown that foods with sugar raise the blood glucose very much like starchy foods. Therefore, the total amount of carbohydrate is more important than whether you’re eating sugar or starch.Small amounts of foods with sugar can be used in your mealplan.
11Use of Sugar in the Meal Plan Substitute sweets for other carbohydrate in the same mealCheck effect on your blood glucose after mealsBut you must substitute them for other carbohydrate-containing foods. If you simply add them to your usual meal plan, your blood glucose will increase.Always check your blood glucose a couple of hours after a meal when trying new foods.
12Role of Sugar in BakingSugar provides volume, texture, moistness, and browningLow-calorie sweeteners only provide sweet tasteWe can’t simply substitute low-calorie sweeteners for sugar in baked foods like you can with beverages.We often think of adding sugar simply for the sweet taste, but sugar goes through certain chemical changes during baking that some foods require to result in an acceptable product.Sugar provides structure, volume and texture to recipes. It also add browning, helps retain moisture and provides tenderness to baked goods. It also has a preservative quality, so foods may not last as long without sugar.
13Sugar in Baking Sugar is needed in yeast breads to raise The quality of many cakes and cookies suffer with reduced sugar or no sugarFor example, yeast will not grow well if sugar is totally removed from bread recipes.Generally the quality of baked goods like cakes and some cookies suffer when sugar is reduced or replaced by a sugar-substitute.
14Low-calorie Sweeteners in Baking Sucralose (Splenda)Aspartame (Equal, NutraSweet)Acesulfame-K (Sweet-One)Saccharin (Sweet ‘n Low, Sugar-Twin)Neotame (recently approved by FDA)Currently 4 low-calorie sweeteners are available for use in the US and 1 additional one, Neotame, has recently been approved by the FDA, but is not yet available in a table-top sweetener.
15Sucralose (Splenda) 600 times sweeter than sugar Stable at high cooking temperaturesRecipes available on web siteHow many of you have used Sucralose, Splenda?It is a relatively new sweetener available in the US, made from a sugar molecule and is extremely sweet. Therefore, you get very little of the sweetener in a serving. It is not digested and absorbed, therefore it doesn’t raise the blood sugar or provide any calories.A nice property about Splenda is that it is very stable in cooking. It comes in granular form to use in cooking and baking which measures like sugar. The packet form is for sweetening beverages or cereal.Recipes are available online.
16Consider Heat Stability of Sweeteners for Cooking or Baking Unstable at high temperaturesAspartame (loses sweetness)Saccharin (becomes bitter)Stable in cooking and bakingSucraloseAcesulfame-KWhen choosing a low-calorie sweetener to use in cooking or baking, consider the heat stability.Aspartame is not stable at high temperatures and will lose its sweetness if cooked at a high temperature or for very long. It gradually loses sweetness over time.Saccharin, although preferred by many people who grew up with it, tends to take on a bitter taste with heat.Sucralose (Splenda) and Acesulfame-K (Sweet-One) do not lose their sweetness when cooked.
17Increase Stability of Aspartame (Equal, NutraSweet, store brands)Add to food after cookingCombine with more stable sweetenerAdd acidic ingredientWith aspartame, it’s best to add it to the food or beverage after cooking like in a pudding or sauce. It can be used in some baked products like cheesecake or pumpkin pie that don’t have a large amount of sugar and are not subjected to extremely high temperatures. Using some sugar or combining with another more stable sweetener may be advisable.
18Low-calorie Sweeteners In general, use when sugar is primarily for sweet tasteFruit fillings (pies, cobblers)CustardsPuddingsBeveragesFrozen dessertsSauces and marinadesLow-calorie sweeteners work best when sugar is needed primarily for taste as in fruit pies, custard pies like pumpkin, beverages, marinades, frozen desserts.You may need to add some extra thickening to fruit fillings, puddings because sugar lends a viscous quality.
19Low-calorie Sweeteners Do not work well as the sole sweetenerin these foods:MeringuesAngel food cakePecan piesPound cakeFoods that require a lot of sugar do not work as well when sugar is totally replaced with a low-calorie sweetener.Meringues and angel food cake will have less volume and stability without sugar.Pecan pies contain a lot of corn syrup - replacing the corn syrup with a low calorie sweetener is not recommended.
20Tips for Using Low Calorie Sweeteners in Baking Cookies, muffins, quickbreads:Honey or molasses will add some flavor and moistnessAdd baking sodaCheck for doneness earlySpecial recipes are often required to get an acceptable product when reducing the sugar in cookies, muffins and quickbreads.You can add 1 Tbs molasses to each cup of sugar you’re replacing to achieve browningExtra soda can help with raising.Foods made without sugar tend to bake more quickly.
21Tips for Using Low Calorie Sweeteners in Baking Cakes:Use molasses or cocoa for browningAdd 1/2 cup nonfat dry milk and 1/2 tsp baking soda for every cup of sugar replacedCombine sugar with low calorie sweetenerCakes without sugar tend to be flat, rubbery, dry and light-colored without much browning if the sugar is replaced with a sweetener.Specific guidelines are listed on Splenda’s web page for adding nonfat dry milk for more bulk, soda to help it raise, and molasses for more color.
22Tips for Using Low Calorie Sweeteners in Baking Fruit fillings, sauces, puddings, custardsAdd thickeningReduce cooking timeIn fruit fillings and sauces, add some thickening as sugar has a viscous quality that sweeteners don’t have and reduce cooking time.
23Choose A Sweetener for Pumpkin Pie What is the purpose of sugar in pumpkin pie?Primarily sweet tasteWhich sweeteners could be used?Equal, Splenda, Sweet-One, or othersAlthough the preference for various sweeteners is very individual, some will be better choices with certain foods.
24Choose a Sweetener for Red Velvet Cake What is the purpose of sugar in a red velvet cake?Volume, texture, tenderness, moistnessWould you use a sweetener? If so, which one?Sugar would work bestCakes work best with sugar. However, you can try using part low-calorie sweetener with instructions on Splenda web site adding additional nonfat dry milk and baking soda.:
25Choose a Sweetener for Christmas Cookies What is the purpose of sugar in cookies?Texture, tenderness, browning, moistness, taste, volumeWhat sweetener would you use?Sugar alone or sugar with Splenda, Equal, Sweet-OneCombine sugar with Splenda?
26Sugar vs Low-calorie Sweetener Pumpkin pie with sugar38 grams carbPumpkin pie with low-calorie sweetener20 grams carbUsing a low-calorie sweetener will reduce your carbohydrate and calories, depending on how much sugar you’re replacing. Making pumpkin pie with a low calorie sweetener saves 18 grams of carbohydrate (1 carb choice or 1 exchange) and saves 73 calories.
27Sugar vs Low-calorie Sweetener 12 ounces Iced Tea with Sugar33 grams carb12 ounces Iced Tea with Low Calorie Sweetener0 grams carbWe often don’t think about sweetened beverages. Compare regular sweetened tea with tea sweetened with a low-calorie sweetener.33 grams of carbohydrate can have a significant impact on your blood sugar.
28Reduce Fat in Recipes Non-baked foods: Substitute fat with non-fat or low-fat ingredientsReduce the fatYou can also reduce the fat in some recipes.You can substitute the entire amount of fat with non-fat or low-fat ingredients in foods that are not baked. Generally, the fat is primarily for flavor in these foods.Examples include banana cream pie, chocolate pudding, strawberry pie, salads like chicken salad.
29Reduce Fat in Recipes In baking: Some fat needed for flavor, moisture, and tendernessFat has a greater role in baked foods. It gives your baked foods flavor, moisture, and a tender texture.If you reduce the fat in your recipe, you should replace it with other ingredients that work in a similar way.Depending on the recipe, you may have a better product if you leave a small amount of the fat in the recipe.
30Reduce Fat in Recipes In baking: Use low-fat yogurt or sour cream in place of regular sour cream in cookies and muffinsReplace fat with 1/2 amount of fruit puree or applesauce1/2 cup prune or bananapuree in place of 1 cupmargarineUsing nonfat or low-fat yogurt, nonfat or low-fat sour cream, and fruit purees (like banana or prune), applesauce, or cottage cheese can provide a lot of the same characteristics as fat in muffins, cakes, cookies, and quick breads.
31Traditional vs Healthy Pumpkin Pie Let’s look at how we can adjust a recipe for pumpkin pie to reduce the calories, fat, and carbohydrate. By replacing the sugar with Splenda and using evaporated skim milk instead of whole milk:We can reduce the calories by 100Cut the carbohydrate in halfReduce the fat by 1/3
33Holiday Meal Tips Identify carbohydrate foods: (carbohydrates raise the blood glucose the most)Starchesbread and rolls, stuffing, potatoes,sweet potatoes, corn, peas, butter beansSugarsfruit, candy, desserts, milk, sodas,sweet tea, eggnogOne of the first things you should do at a holiday meal is to identify the foods that contain carbohydrate. They will have the most effect on your blood glucose.
34Holiday Meal Tips Eat usual daily amount of carbohydrate Space out carbohydrate based on timing of holiday mealAdjust insulin based on carbohydrate if you’ve been trainedCheck blood glucose regularlyThe most important factor in keeping your blood glucose in check is to keep within your usual daily carbohydrate range. The more carbohydrate you eat at a meal, the higher your blood glucose will rise after the meal. So, for most people with diabetes, it’s best to space it fairly evenly throughout the day.If you take the short-acting insulin at each meal, you can adjust your insulin based on how much carbohydrate you plan to eat.Check your blood glucose 2 hours after meals to see what your usual range is. (A general guideline is less than , but you and your doctor may choose to go even lower).
35Holiday Meal Tips Fill up on low-calorie salads and vegetables Avoid second helpingsUse high-fat condiments sparinglySmall portion of dessert can be eaten in place of other carbohydrate foodsTo minimize the extra calories and high blood sugars, don’t forget to include vegs and lettuce salads (other types of salads can be high in fat and carbohydrate)Go light on the gravy, sauces and butter.A small amount of dessert can be eating in place of other CHO foods.
36Estimating Portion Sizes 1 cup pasta = woman’s clenched fist½ cup vegs = ½ tennis ball1 fruit serving = 1 tennis ball3 ounces meat = deck of cards1 teaspoon = thumb-tip1 tablespoon = 2 thumbs pressed together
37Make Smart Food Choices 63 grams carb1 piece pecan pie(1/8 of pie)58 grams carb1/2 cup mashed potatoes1/2 cup stuffing1 roll1/2 cup green beans3 ounces turkey2 Tbs. gravyTossed salad with Italian dressingJust to keep it in perspective:A piece of pecan pie has a whopping 63 grams of carbohydrate equal to the amount of carbohydrate in an entire dinner of potatoes, stuffing, roll turkey and veg and salad.In other words, a piece of pecan pie will raise your blood sugar about the same amount as the turkey meal.
38Holiday Meal 3 ounces turkey 1/2 cup stuffing (20 grams carb) 2 Tbs. gravy1/2 cup green beans (5 grams carb)Tossed salad with Italian dressing1 slice pumpkin pie (38 g carb - sugar)(20 g carb with sweetener)To stay within the 60 grams of carbohydrate, you could have a nice meal with a piece of pumpkin pie. Use a low-calorie sweetener and you only get 45 grams of carbohydrateTotal carb: 63 grams (45 grams)
39Traditional Holiday Dinner Waldorf SaladRoast Turkey/gravyGreen Bean CasseroleMashed Potatoes/GravySausage Stuffing/gravyCranberry SauceDinner rolls with butterPecan PieAlternativeLow-fat mayonnaiseWithout gravyPlain beans or ff soupEliminate gravyAvoid sausageSF cranberry relishEliminate butterPumpkin PieCan you give suggestions to lighten this meal to make it more diabetes-friendly?Pecan pie: 503 calories, 63 CHO, 27 g fatPumpkin orsweet potato pie: 285 calories, 40 g CHO, 12 g fat
40Attending Holiday Parties Plan ahead what you will eatOffer to bring a healthy dishEat something light at home to curb your appetiteParties are difficult for many people. It’s best to decide ahead of time what and how much you’ll eat.Offer to bring a healthy dish - that way you’ll ensure that there’s at least something healthy for you to eat.Don’t go to the party famished - you’ll eat too much. Instead, if you’re very hungry before the party, eat something light at home to curb your appetite.
41Attending Holiday Parties Skip second helpingsAvoid lingering near buffet tableMingle with guests - you’ll eat lessAvoid the temptation to have second helpings - extra carbohydrate and extra calories. Try to stay within your usual portion sizes.Don’t hang around the buffet table - it’s too tempting. Instead, mingle with guests. You’ll eat less if you’re talking.
42Limit Alcoholic Beverages Reduces willpowerAdds extra poundsCan cause hypoglycemia if taking insulinAlways eat something when drinkingAlcohol reduced willpower, so many people tend to eat more when they drink.Alcohol contains extra calories and often it is mixed with high-calorie mixers (Eggnog)People taking insulin can experience low blood sugar after drinking alcoholic beverages, so it’s best to eat something when drinking.American Diabetes Association recommends:Women: limit to no more than 1 drink in a dayMen: Limit to no more than 2 drinks in one daySome people should not drink at all - those with high triglycerides, neuropathy, and those taking medications that interact with alcohol (look on medication bottles)
43Holiday Entertaining Reduce stress by planning ahead Ask people to bring a dishDon’t try to be a Martha StewartGet enough sleepEntertaining can be very stressful. Planning ahead will help tremendously.Don’t try to do everything yourself. Ask others to bring a dish. Get your family involved in preparing for the party.Get plenty of sleep. You’ll be able to deal with the stress more effectively.
44Reduce Your Stress Plan ahead Make a shopping list Take a vacation day to do your shopping or holiday bakingSchedule physical activityWays to deal with the holiday stress:Make lists of things you have to do for the holidays:people you need to buy gifts for, the type of gifts, holiday baking or cooking you need to do.If you feel like you don’t have enough time, take a vacation day to do your shopping or holiday bakingSchedule physical activity in every day. You’ll be amazed how much better you deal with the stress.
45Enjoy Your Holidays Don’t set your expectations too high Enjoy your holiday festivitiesRemember that no one is perfect - don’t set your expectations too high. Your overall diabetes control won’t suffer with a little indiscretion. Enjoy the special times and a few special meals, but remember to get right back on track the next day.Keep checking your blood glucose regularly so you know how you’re doing.Remember the whole purpose behind the holidays and try to experience the enjoyment..
47Practical Non-food Gifts to Give or Receive PedometerExercise videoWalking shoesExercise clothesFitness classGift certificate to spaHealthy cookbookSome good non-food gift ideas for people with diabetes or anyone include:pedometer to measure steps and motivate people to move moreexercise videoswalking shoes, cushioned socksappropriate clothes for exercisinggift certificates to a spa or health clubhealthy cookbook - Example of a holiday cookbook:The American Diabetes Association’s Mr Food’s Everyday’s a Holiday Diabetic Cookbook (www.diabetes.org) (2002)