Talking Turkey Incorporate Healthy Options into Your Thanksgiving Meal

November is Diabetes Awareness Month, and the numbers are sobering. It is estimated that one in three American adults will have diabetes in 2050, and an additional 79 million Americans are at high risk for developing type 2 diabetes, which occurs when the body cannot utilize its insulin and does not produce enough to mobilize glucose from the bloodstream to the muscles and organs for energy.

When it comes to our children, the numbers speak for themselves: 8.3{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Americans have type 2 diabetes, with one-third of new type 2 cases — once affecting primarily adults — diagnosed in youths from ages 10 to 20. These numbers are high and are continuing to rise alongside the obesity epidemic, which places our children at risk for a number of diseases that may begin as early as childhood and continue into adulthood.

What is concerning is that uncontrolled type 2 diabetes in obese children can lead to life-threatening complications as they grow into adults, including cardiovascular disease, kidney disease, blindness, and nerve damage leading to amputations.

It may not be coincidental that the month of November is chosen to bring attention to the epidemic of diabetes in our country, as the holidays from Thanksgiving through the New Year pose the greatest challenge for those who are obese and/or have diabetes.

When it comes to the temptations of the annual Thanksgiving Day feast or other holiday meals this season, the American Academy of Dietetics has its own recommendations that hold true not only for children with diabetes, but adults as well. It suggests:

Starting the day with a good breakfast that includes whole grains, fruit, dairy foods, and protein;
Not starving oneself before the big meal. This can be harmful for those taking diabetes medications or insulin. Also, the longer one goes without eating, the more one eats when sitting down for the meal;
Knowing one’s carbohydrate goal for each meal and trying to stick to it for good blood sugar control;
Watching liquid calories such as juices and sodas, which can pack a real punch in terms of carbohydrates (including alcohol for adults). Drink water or sugar-free beverages instead;
When making cookies, pies or cakes, substituting traditional baking ingredients with healthier options to help lower trans fat intake. Go easy on foods with hydrogenated or partially hydrogenated oils. Switch to oils or trans-fat-free margarines. Add healthy ingredients to cake or cookie batters, such as raisins or toasted nuts instead of chocolate chips.
Control is always easier when you are the cook and you are preparing the meal at home with your child with diabetes in mind. Remember, typical Thanksgiving foods containing carbohydrates include potatoes, stuffing, breads, rolls, corn, peas, squashes, cranberry sauce, and desserts. Talk with your child ahead of time to see which foods he or she absolutely must have and those they can do without.

Turkey is a healthy choice and a good source of protein, but don’t serve your child the crunchy skin, which is full of fat. As for stuffing the holiday bird, consider using whole-wheat bread and a reduced-sodium chicken broth instead of butter to moisten it, as well as mixing in some chopped vegetables or even fruit. For potato lovers, mashing or roasting with olive oil and fresh herbs are delicious ways to prepare potatoes for the holidays. Also, it’s not every child who likes sweet potatoes, but for those who do, leave the butter, sugar, and marshmallows behind and instead try sweetening them with sugar-free maple syrup and topping them with chopped pecans.

Healthful dessert ideas include homemade, low-fat oatmeal cookies, a fresh fruit yogurt parfait, and a pumpkin pie made with fat-free evaporated milk.

When celebrating Thanksgiving at someone else’s home, especially in a situation where they ask you to contribute to the dinner, we tell parents to bring something healthy. For example, if they want you to bring an hors d’oeuvre, then bring a healthy vegetable platter with low-fat yogurt dip as opposed to pigs in a blanket. If you are asked to bring a main course, consider mashed potatoes prepared in a healthy way with skim milk to lower the amount of cream. Or, if it’s a dessert, then bring some fruit since there is sure to be plenty of pies and cakes at the dessert table.

Also, talk to your children beforehand. Let them know that they will soon be faced with a table filled with foods and a free-for-all as everyone grabs for their favorites. Since the best goal for them is no seconds, suggest that they enjoy themselves by filling their plate with a little of everything, just as long as it’s not piled as high as the plate is wide.

It’s also important for children to remember to check their blood sugars, because diabetes doesn’t take a day off and neither can they when it comes to their diabetes management. Don’t forget to take your child’s glucose meter and diabetes supplies along to your holiday destination. This is not a day to forget to take one’s medication, and for those taking insulin, it’s especially important that they count their carbs as accurately as possible.

As for the leftovers, leave them behind. Everyone tends to overdo it a little at a holiday meal, but that’s not a license to continue when you walk away from the table. If you’re at someone’s home and they offer you a plate to bring home, politely decline so that you can return to your regular healthy eating for the rest of the week and beyond.

And it’s always a good idea to eat less and move more. After your holiday meal, don’t let the kids play video games or listen to their iPods for hours on end, while the adults turn on the television to watch football. Take a family stroll afterwards or go biking, depending upon the situation. Remember, a good, brisk walk will not only help burn off those extra calories, but, especially for diabetics, will lower their blood sugar levels.

There is importance to the suggestion of taking a ’family’ stroll. When it comes to helping a child make lifestyle changes — eating more healthy foods and exercising more — to combat his or her increasing weight, the entire family must be involved. Parents must set an example for their children by eating healthy and being active as well.

As for the answers to the obesity epidemic and the resulting increase in type 2 diabetes … that could take an entire column. But the short response is that incorporating healthy habits to your own daily routine, as well as your child’s, will promote a healthier lifestyle, lead to weight loss, and reduce one’s risk of developing obesity-related diseases such as diabetes. While the holidays are associated with overeating and eating less-than-healthy foods, they don’t have to be. Planning ahead and making smart choices will allow you to enjoy the holidays without suffering from the repercussions later.

Dr. Rushika Conroy is with the Division of Pediatric Endocrinology at Baystate Children’s Hospital. Paula Serafino-Cross is a clinical dietitian at Baystate Medical Center.