‘Tis the season! Though it’s hard to believe we are already entering the holiday season, the festivities are in full swing! The holidays are truly a wonderful & festive time of year, but for people with diabetes it can also be highly stressful & distruptive to daily routines. With the holidays, comes a big focus on food … LOTS of food. And for those struggling to manage diabetes, all this talk of food can pose some challenges making it harder to manage. But with a little advanced prep work, those living with diabetes can eat all of their holiday favourites without compromising their blood sugar goals!

1. Plan Ahead & Maintain Consistent Meal Times: It is a good idea to plan in advance for how you will make changes to your usual routine if your holiday meal does not align with your regular meal schedule (e.g., eating dinner at 8:00 pm versus your usual 5:00 pm). Going long periods of time without eating can make it more difficult to control blood sugars & it may predispose you to overeat at a meal when you finally do sit down to eat. It may be helpful to plan to have a small snack or smaller meal portion at your usual mealtime to help keep blood sugars stable in these cases, especially if you take insulin or an oral medication that can cause low blood sugars. Avoid fasting before a big holiday dinner as this may increase the risk of overeating later on & it makes it more challenging to control blood sugars. It is best to eat your regular meals or snacks as usual prior to any holiday event.

2. Be Selective at Meals: Many favourite holiday foods are high in carbohydrates. Carbohydrates are those foods that will break down into sugar when eaten & therefore will directly impact blood sugars. Carbohydrates are found naturally in foods like: mashed potatoes, sweet potatoes, stuffing, dinner rolls, corn, rice, cranberry sauce, breading-based casseroles, pies, Christmas cake or pudding as well as other desserts. Don’t feel like you have to sample everything on the table – have a reasonable portion of your favourite foods & pass on the rest for another time. If you really want to try everying, make your portions smaller!

3. Fill Your Plate with Vegetables First: By filling your plate with vegetables first, you decrease the amount of space left for those less nutritious options. Aim to fill 1/2 of your plate with vegetables, 1/4 plate of protein & 1/4 plate carbohydrate. Be mindful of those starchy vegetables that contain carbohydrates & therefore raise blood sugars . Consider the following options as carbohydrate choices vs. a vegetable serving: potatoes, sweet potatoes, corn, squash, parsnips, pumpkin, etc.

4. Follow the 80/20 Rule: Give yourself permission to be flexible with your eating behaviours over the holidays. The holidays are a joyous time to spend with friends & family celebrating. And with celebrations, often comes food. For many people food is SO much more than just basic nourishment & is meant to be enjoyed. People who are rigid, all-or-nothing thinkers however often find the holidays & all the accompanying food incredibly stressful. These people often find the smallest slips in their eating as a failure & struggle getting back into healthy habits.  Try not to let one instance of overeating cause you to give up & indulge in a “lost weekend of excess!” Learning to become more flexible in your eating can help to establish long-term healthy habits that are moderate & realistic. It is unrealistic to expect to eat “perfectly” 100% of the time; we all need a treat every once in a while! It is actually helpful to plan on having a treat every once in a while so that you can indulge while still feeling in charge. By adopting the 80/20 mindset you aim to eat healthily approximately 80% of the time & the remaining 20% of the time (e.g., holidays, birthdays, anniversaries, celebrations, etc.) you open your diet up to less healthful choices & you do so guilt free without feeling deprived.

5. Avoid or Limit Alcohol & Other Sugar-Sweetened Beverages: If you drink alcohol, try to limit how much you drink & pair it with a meal. Alcohol can be a big source of “empty calories,” with lots of energy but little nutrition which can make it difficult to control blood sugars. Plus, alcohol can actually contribute to low blood sugars for those who take insulin or insulin secretogogues such as Diamicron (Gliclazide) or Glyburide. Try to keep your intake of alcohol to no more than 2 drinks/day for women & no more than 3 drinks/day for men. A standard drink size looks like:

– One 12 oz (341 mL) beer of 5% alcohol content

– One 12 oz (341 mL) cider of 5% alcohol content

– One 5 oz (142 mL) glass of wine of 12% alcohol content

– One 1.5 oz (43 mL) shot distilled alcohol (rye, gin, rum, etc.) of 40% alcohol content

Be cautious of consuming beverags with high-calorie mixers such as regular pop, juice, margarita/daquiri mixes, tonics, etc. that are high in added sugars & extra calories. Try to choose sugar-free mix options in these instances. Popular holiday drinks such as apple cider, hot choolate, egg nog, lattes/cappucionos, etc. are also high in sugar & should be enjoyed in moderation only.

6. Slow Down & Enjoy Your Favourite Foods:  Life is busy, especially during the holidays & it is not uncommon to scarf down our favourite foods quickly without even realizing what we are actually putting into our mouths or how quickly we have just eaten. But eating too much, too quickly can negatively impact your blood sugars & overall health, so it’s important to find ways to slow down so you can actually enjoy your meals. How many times have you gone back for a second or third helping of stuffing only to end up slumped on the couch in the throes of a “turkey coma” an hour later? People often eat more than intended at meals, simply because they are not aware that they are already full & satisified. It takes 20 minutes from the start of a meal for the brain to recognize fullness after eating. To slow down your eating, you may find it helpful to consider the following strategies:

• Avoid distractions (e.g. watching TV, texting, working, etc.) when eating
• Put down utensils between each bite of food
• Set a minimum number of chews per bite (start with 5-10 chews to start)
• Set aside time to eat; ideally 20-30 minutes at least
• Try using utenzils that slow down your eating (e.g. spoon instead of a fork or chopsticks!)
• Check in with your hunger/fullness level half way through the meal

7. Stay Active: Keeping active is an important part of diabetes self-management & can help keep blood sugars stable when we indulge more in our favourite foods. Physical activity has also been known to help decrease stress especially during one of the most overwhelming times of year & can help bond family/friends together if doing it together. Choose acivities that you enjoy to help increase the odds you will actually particpate!

8. Manage Stress: Thought the holidays can be fun, for many it can actually be quite stressful & bring up a lot of negative emotons. For many, the holidays can make people feel out of control trying to juggle differing demands. With a little planning however, you can learn to minimize the stress so you can enjoy the holidays more.

• Acknowledge your feelings; it is okay to feel sadness, grief, anger, etc. even during the holidays & by acknowledging the feeling, you take away the power it has over you.
• Reach out to friends & family if you are feeling isolated, alone, anxious or depressed. Seek out community, religious or other social events in your area for extra support & companionship.
• Be realistic with your holiday expectations & simplify holiday commitments & traditions. It’s okay to re-evaluate past traditions & change them for the coming years.
• Allow time for yourself to do the things you like to do.  Rest when you feel you need to.
• Try to set aside differences with family & friends.
• Ask others to help with holiday get-togethers.

9. Adjust Your Favourite Recipes: Again, with a little planning, you CAN party healthy without abandoning your goals. Consider a few of these holiday substitutions:

a) To Reduce Sugar:

• Use extracts (e.g. mint, almond, vanilla, etc.) and/or sweet spices such as cinnamon, nutmeg or ginger
• Reduce the amount of sugar used in baked goods by 1/4 to 1/3 cup without impacting the quality of the food
• Use pureed fruit instead of syrups
• Make use of artificial sweeteners such as sucralose or steviol glycosides
• Replace whipped cream with chilled evapourated skim milk
• Replace semi-sweet chocolate (1 oz) with 3 tbsp cocoa powder & 2 tbsp canola oil

b) To Reduce Fat:

• Replace up to 1/2 the fat called for with mashed fruits or vegetables (e.g. applesauce is a good replacement for butter or oil!)
• Reduce fat by 1/4 to 1/3 cup without impacting the quality of the food
• Line baking pans with parchment paper or use silicon baking pans & trays instead of greasing the pan
• Replace full fat sour cream with a light or low fat version or consider replacing with plain Greek yogurt
• Replace heavy cream with 2 tbsp flour in 2 cups skim milk
• Steam vegetables instead of sauteing in butter or oil
• Use 2 egg whites in place of 1 egg

c) To Reduce Salt (Sodium):

• Instead of salting foods for flavour, consider flavouring with fresh or dried herbs (e.g., garlic powder, thyme, parsley, etc.)
• Use lower sodium versions & smaller amounts of store bought sauces, gravies, side dishes & condiments (e.g. gravy, instant potatoes, boxed stuffing, etc.) 
• Choose low sodium or no salt added canned products
• Cook pasta, potatoes, rice, etc. without adding salt
• Choose unsalted nuts/seeds & low sodium chips, crackers, pretzels, etc. 
• Look for products with food labels that say “sodium-free,” “low sodium,” “reduced sodium” or “no salt added”
• Ask for sauces & salad dressings on the side & consider using smaller amounts

d) To Increase Fibre:

• Replace up to ½ white flour with whole wheat flour
• Replace 1/4 flour in a recipe woth ground flax
• Look for recipes that have been trialed using whole wheat flour
• Keep the skins on fruit, potatoes, carrots, etc. when cooking
• Look for crackers & bread products made with whole grains

10. Get Your Sleep: Going out more & staying out later often means cutting back on sleep. But not getting adequate sleep can make it harder to manage blood sugars & control cravings for fat, sugar & salt. Aim to get 7-8 hours of sleep during the holidays to help prevent mindless eating.

11. Check Blood Sugars More Frequently & Have a Plan in Place for Low or High Blood Sugars: If you check your blood sugar, you may find it helpful to check your sugar more frequently, especially if you are going long hours without eating, are consuming alcohol or eating a lot of high carbohydrate foods. Make sure you have a plan in place in order to treat a low blood sugar or high blood sugar approrpiately.

Remember, the holiday season is all about celebrating & connecting with the ones you care about most. If you slip up in your eating or overindulge, try not to think of it as a failure. Slips happen & are a normal part of life. Don’t beat yourself up! Be curious about why the slip happened, then make a plan to get back on track to meet your goals for the year ahead!

References:

https://www.cdc.gov/diabetes/library/features/holidays-healthy-eating.html

https://www.diabeteseducator.org/docs/default-source/legacy-docs/_resources/pdf/general/AADE_Holiday_toolkit.pdf

https://www.canr.msu.edu/news/diabetics_can_enjoy_foods_associated_with_the_holidays_and_still_stay_healt

https://www.diabetesfoodhub.org/articles/6-tips-for-a-happy-healthy-holiday-with-diabetes.html

https://www.lvhn.org/news/managing-diabetes-during-holiday-season

https://www.camh.ca/-/media/files/canadas-low-risk-guidelines-pdf.pdf