1. Power Choices for the Holidays – Dining with Diabetes Presented by: Lisa Barlage, Extension Educator, FCS, Ohio State University Extension, Ross County barlage.7@osu.edu

2. Objectives and Disclosure: Discover diabetes friendly substitutions for common holiday meal favorites. Identify the most common recipe staples to keep in stock. Demonstrate simple diabetes friendly cooking options. There is conflict of interest to disclose.

3. The holidays can present special challenges for those with diabetes...  Busy schedules  Extra stress  Family gatherings  Eating out  Foods rich in carbohydrates, fats, and sodium  Foods high in calories

4. Why worry about diabetes management during the holidays? The holiday season goes from Halloween to New Year’s = 2 months With busier schedules, there is less time for exercise Researchers have found that weight gained during the holidays usually doesn’t come off later in the year Increased weight leads to increased difficulty managing your diabetes

5. You have the power to manage your diabetes and Enjoy the holiday season!

6. Cut stress and stay active Stress effects your diabetes  The “fight or flight” effect  Continued high stress can lead to difficulty managing your glucose Staying active can help you manage your diabetes  Plan activity into your day  Train for and participate in a local holiday run/walk event  Incorporate activity into time with friends and family  Go for a walk after eating a holiday meal  Clear the table after a meal – this will get you active and prevent mindless munching

7. Stay on track - plan ahead Your schedule  Think about your holiday gatherings, travel, and events  Try to maintain balance – medication, healthy foods, physical activity Your meals  Stick to your healthy meal plan  Plan menus in advance so you are not putting meals together at the last minute  Take diabetes-friendly foods to gatherings

8. Try these holiday meal tips Slow down  Focus on friends and family  Enjoy the foods you are eating Remember to keep your carbohydrates consistent  Try to have the same amount of carbohydrate you normally would  Don’t skip meals or snacks earlier in the day to “save” carbs for later. This will make your blood glucose more difficult to control. Keep desserts in check  Share  Take desserts you have modified to be healthier  Politely decline when you know you have reached your limit

9. Watch your portions  2 stacked dominoes = 1 oz of cheese  Deck of cards = 3 oz. of meat  Baseball = medium potato or fruit, 1 cup cold cereal  Compact disk = pancake  Computer mouse = ½ cup pasta  Diameter of a yo-yo = small cookie

10. Holiday foods can be high in sugar, fat and calories

11. Extra calories can sneak in during the holidays... And they don’t always come in LARGE portions Chocolate cake, iced 650 calories per 2x2 inch slice Pecan pie 500 calories per 1/8 pie Egg nog 342 calories per 8 oz. Pumpkin pie 290 calories per 1/8 pie Holiday cookies 150 calories per 2 cookies

12. Making your holiday favorites healthier Reduce the sugar:  Use less  Replace with non-nutritive sweetener Reduce the fat:  Ingredient substitution  Portion control Reduce the sodium:  Use less  Ingredient substitution Increase fiber:  Add fruits, vegetables, and whole grains

13. Dining with Diabetes Holiday Meal Make-Over On the Menu Roasted Turkey Breast Apple Stuffing Skinny Gravy Sweet Potato Puffs Green Beans, Cranberries, and Nuts Double Layer Pumpkin Pie

14. Let’s Talk Turkey Turkey is a healthy, low-fat meat, if you choose the right part Selection (3.5 oz)Fat (g) Turkey skin39 Roast beef15 Turkey wing with skin12.3 Turkey leg with skin11.5 Roasted ham9 Turkey breast with skin7.3 Turkey leg without skin7.1 Turkey breast without skin0.7 Source: USDA database

15. Make healthy modifications Holiday Apple Stuffing: Use a lower-sodium broth and stuffing mix Add fruits and vegetables to increase flavor, color, and fiber content Add whole grains like brown rice, barley, and wheat berries

16. Compare ½ Cup stuffingCaloriesCarbsFatSodiumFiber Home-made1902266431.0 Box mix 1702185200.5 Apple Stuffing 78160.71551.0 Fitness Connection: You would need to walk... 60 minutes to work off the home-made stuffing 50 minutes to work off the box-mix stuffing 24 minutes to work off the apple stuffing

17. “Skinny” gravy Use fat free broth or de-fatted drippings as a base Skim the fat of meat drippings from the meat Use cornstarch in place of a higher fat “roux” made from flour and fat

18. Compare ¼ Cup GravyCaloriesCarbsFatSodium Home-made82.556340 Commercial4032.5420 “Skinny” Gravy920112 Fitness Connection: You would need to clean... 24 minutes to work off the home-made gravy 12 minutes to work off the commercial 2 minutes to work off the skinny gravy

19. Sweet Potato Options Use orange juice or apple juice Add spices, such as cinnamon, cloves, nutmeg, or ginger Omit sugar and butter Use half the amount of marshmallows or use raisins instead Mash and bake to make sweet potato puffs

20. Compare ½ CupCaloriesCarbsFatSodiumFiber Regular253467.42402 Sweet Potato130233202 Puffs Fitness Connection: You would need to bike... 40 minutes to work off the regular sweet potato casserole 20 minutes to work off the sweet potato puffs

21. Green Beans with a Twist Use fat free half & half in place of cream soup Add colorful fruits, like cranberries, or veggies, like carrots or corn, to add color and give a fiber boost Top with minced onion and parmesan cheese instead of fried onion rings Add nuts and seasoning

22. Compare ½ CupCaloriesCarbsFatSodiumFiber Regular12512.574952 Green Beans798.4502.2 Cranberries, and Nuts Fitness Connection: You would need to jog... 20 minutes to work off the regular green bean casserole 12 minutes to work off the green beans, cranberries, and nuts

23. Tips to Make a Delicious, Better for You Pie Omit the bottom crust for fruit pies Use ground ginger snaps in place of traditional pie crust Use a ready-made pie crust – it is thinner than homemade versions, thus typically contains fewer calories, less fat, and fewer carbohydrates Use egg whites in place of whole eggs Use evaporated skim milk Cut into 10 servings Top with fat-free whipped cream

24. Crust comparisons 1/8 th CrustCaloriesFat Gingersnap601 Graham1095.5 Ready-made1208 Homemade16011

25. Try our Double Layer Pumpkin Pie Use less sugar Add sugar-free pudding mix to add volume without calories Spice it up – add cinnamon, ginger, cloves, or try a prepared pumpkin pie spice

26. Compare 1/10thCaloriesCarbsFat Homemade Pie168247 Commercial Pie16921.78.4 Double Layer96135 Pumpkin Pie Fitness Connection: You would need to rake leaves... 35 minutes to work off the home made or commercial pie 19 minutes to work off the double layer pumpkin pie

27. Cookie Considerations Make them smaller Make fewer varieties Serve cookies with fresh fruit Cutting fat doesn’t really save on calories if it is replaced with sugar and flour – these add carbs!

28. Compare CaloriesCarbsFat Traditional Holiday Dinner983.5109.540.7 Modified Holiday Dinner50162.414.4 You Saved: 482.5 Calories 47.1g Carbohydrates 26.3g Fat

29. Celebrate the happiness that friends are always giving, make every day a holiday and celebrate just living! ~ Amanda Bradley

30. Credits Developed by the Ohio State University Extension Diabetes Education Team Christine Kendle, OSU Extension Tuscarawas County Shari Gallup, OSU Extension Licking County Amy Habig, OSU Extension Adams, Brown, and Highland Counties Kate Shumaker, OSU Extension Holmes County 2013 Resources: American Diabetes Association, www.diabetes.orgwww.diabetes.org Brinkman P, Syracuse C. Modifying a Recipe to be Healthier. Ohio State University Extension Center for Disease Control and Prevention, www.cdc.govwww.cdc.gov Henneman A. Tiny Tastes can add up to Big Calories During the Holidays. University of Nebraska Lincoln Extension. Mayo Clinic, www.mayoclinic.orgwww.mayoclinic.org