Holidays mean family gathering and food eating. Lots of it. Of all kind. And all tasty. How is it possible to resist eating all these succulent dishes? How to work around the meal schedule? People with Type 1 diabetes must see the Holidays as a period no different than the rest of the year: follow your meal schedule and stick to the food you can eat. Here are some tips to help you do that.
- If you’re invited to a gathering, make sure at least one person you trust knows your condition and how to recognize symptoms of lows, so that he/she can contact a close relative of yours or call 9-1-1 if you feel bad.
- Remember that in doubt, test yourself. A little poke can go a long way making the gathering a fun one instead of turning it into a health issue.
- Make sure you wash your hands before each poke because you’ll carry a lot of germs with all the handshaking going on and some will otherwise make their way into your bloodstream. Dry your hands with a clean paper towel, and use it to open the bathroom door on your way out (avoid touching the knob with your bare hands). You’re not being snob, you just take care of your condition.
- Each child and adult responds differently to parties. The stress, the excitement and the exercises (running around) can result in glucose swings, usually lows. Be ready to overcome a low by carrying food with you to quickly raise your glucose if need be.
Before a Meal
- Skip the appetizers and crackers with a pile of stuff on them. They are loaded with carbs, usually simple sugars (instead of the better complex carbs) and will quickly raise your glucose. Aim for veggies (but skip the salsa and dressing), slices of lean meat or cheese which contain no carb and have no direct effect on your glucose.
- Avoid alcohol, for two reasons. First, when you drink, your liver stops releasing glucose (as it eliminates the alcohol from your bloodstream); during that time, sometimes hours after drinking, your blood glucose can be dangerously low. Second, some people exhibits the same symptoms as light drunkenness when they are low, so it’s hard to tell if you act differently because of low glucose or the effect of alcohol. Some have ended their parties at the hospital because they did not recognize the symptoms and experienced a severe low.
- Remember your meal schedule: meals can’t be skipped nor delayed for too long because you may experience a low. Test yourself at the time you would normally start eating, and if you are getting low, start consuming some carbs (e.g. 1 or 2 whole wheat crackers with slices of meat or cheese) every 20 min. or so until the meat comes up. If you become very low, aim for simple sugars (sweets, juice, etc.) to quickly raise your glucose.
At Meal Time
- Look for complex carbs from whole wheat products. Avoid white bread, white rice, “enriched” pasta (the regular type of pasta commonly found in stores). Bring some dishes (for everybody and yourself) if you’re invited. This allows you to consume high-quality food that slowly release glucose.
- Survey the dishes to find out what you will take. Look for simple dishes that contain few ingredients. A dish consisting of multiple ingredients such pasta, beans, meat, cheese and some “stuff”, or a salad with chunks of fruits, croutons, etc., or a cake (overloaded with simple sugars and maybe fruits) all make it difficult to calculate the carbs. It’s better to skip a dish than end up with a high or a low hours after. Again, consider bringing some dishes yourself because you’ll know what they contain.
- Allow yourself a carb budget, say 60 CHO, so that you can administer the right amount of fast-acting insulin just before the meal.
- Eat slowly and stick to your carb budget.
After the Meal
- Check yourself two hours after the last bite to see if you’re too high or low. If you’re high, go exercise (play outside) to lower your glucose. But mostly watch for lows, which allows you to eat a little more. Remember that the maximum glucose lowering effect of a fast acting insulin is about 1-3 hours; after that your glucose may start to go up.
This is the time of year where we donate to food banks for the less fortunates. The intent is always a good one, but not necessarily the gift. Too often, the food given is of poor quality: high in sodium, high in simple sugars, high in fat content… the kind of food people with Type 2 diabetes, high-blood pressure and/or weight issues must avoid. Food banks are instead asking for whole wheat products (bread, pasta, rice), fruits in cans low in sugars, fruit juice made with… real fruit juice (not fructose, artificial flavor and water), beans without added fats and fiber-rich cereals.
J.M. Smuckers recently announced a food recall on some of its peanut butter products. Food recalls seem to happen all the times. Read more about this on our new Food Contamination page.
Type 1 diabetes is an uncontrolled reaction of the immune system that destroys a type of cells in the pancreas, called beta cells. The reaction starts with month-old babies, and continues until every beta cell is destroyed, a process that takes just a few years (months in some cases). Because beta cells can’t be regenerated, and there’s no cure, children are afflicted with the disease for their entire life, with severe complications in some cases. The cause is unknown, but it is on the rise in the population, which indicates it’s not genetic only. There are strong indications that cow’s milk initiates the disease. It’s possible that by having fed those children different food when they were young, they would have lived a diabetes-free life.
Food allergies are another aggressive reaction of the immune system whose origin is unknown, manifest itself at a young age, and can last a lifetime. For people suffering from them, their body sees specific food as intruders and react to destroy it. The reaction can be so violent that people can die within minutes. The most common food allergens in the US are cow’s milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat. Food allergies affect 4 children out of 100.
Peanuts is a common food allergen. Peanut plants are susceptible to a mold the produces aflatoxin, a powerful agent that causes cancer, and traces of it can be found in peanuts we consume. Peanut butter also contains some. Worse, peanut butter is often recalled due to E. coli or Salmonella contamination when mishandled (by negligence or intentionally). The FDA is sometimes well aware of contamination issues with plants but lacks the authority to force a recall. There’s currently a voluntary peanut butter recall by J.M. Smucker Co. because of Salmonella contamination of its products.
Just like Type 1 diabetes, food allergies can’t be linked to genes only. There’s clearly something else that triggers them, because their rates are increasing faster than ever. Unbiased studies point toward the food, and that makes perfect sense. Either the food is not tolerated because it’s not meant for us (e.g cow’s milk) and/or is processed inadequately (e.g. peanuts and derivatives).
Today, US News mentions a report that consuming diets rich is unsaturated fat (e.g. olive oil, avocados) may help the body to use insulin. It’s the preliminary result of a study comparing 1) a high-carb diet (rich in pasta and white bread), 2) a protein-rich diet and 3) a diet high in unsaturated fat. The latter improved the bodily use of insulin the most, and therefore should be preferred over the two others.
Does that mean people with diabetes should go for such a diet? Not at all.
First, a diet mainly consisting of simple sugars (as found in white pasta and white bread) will have detrimental effects on anyone with diabetes. Studies have shown that people following a high-carb diet rich in complex carbs (whole wheat food) experience must better control over their insulin.
Second, diets containing high amounts of fats are clearly related to the development of Type 2 diabetes.
Third, olive oil is made of ~14% of saturated fat, itself very aggressive at promoting heart diseases, and there’s no study that shows that monounsaturated fat can stop or reverse artery diseases. Since diabetic people are at a higher risk of suffering from cardiovascular diseases, it’s better to keep the arteries clean by avoiding fats. Diets that avoid fats of any kind fare much better results regarding cardiovascular outcomes.
A report like this simply adds more confusion to the choices diabetic people face daily because it is flawed from the beginning and its conclusion may lead to other complications in the long term.
Here’s a great article from the American Heart Association about reading food labels. Plus, it explains what regulated expressions like “calorie free”, “sugar free”, “fat free”, “low fat”, etc. really mean, and it’s often not what their names suggest.