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Cooking for the Family - Healthy Holiday Meals">
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ADA Moderator : Welcome to ADA Live! Today our guest is Jackie Newgent, a registered dietitian, and author of the new The All-Natural Diabetes Cookbook , published by the American Diabetes Association. She joins us today to provide tips and answer questions on how to enjoy eating healthfully, especially with the holidays fast approaching.
Jackie, the holidays can be a challenging time for any of us who are watching our weight or trying to manage health conditions such as diabetes. But you say you have some good news for us - that we can still enjoy favorite foods by making some small but important changes.
Tell us more.
Jackie Newgent: Thanks. It's a pleasure to be here. The best way to tell you more is to jump right into the great questions we have already.
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ADA Moderator : Sound great Jackie. The first question seems like the most obvious on for people with diabetes. Are there any foods I should avoid during the holiday season?
Jackie Newgent: The easy answer to that is "No!"But as a dietitian, I like to suggest focusing on foods you can include, rather than foods to avoid. For example, you can include your favorite treats if you do so in moderation, in appropriate portions, and when properly planned into your individualized eating plan. That way you won?t feel deprived--and you'll be including your favorites in a healthful way. People with diabetes need to look for ways to balance favorites within an overall healthful diet rich in vegetables, whole grains, lean meats, legumes, non-fat dairy and fruits. If choosing one diet change, I always suggest focusing on eating more non-starchy veggies. One of my favorite tips is to drink your vegetables. For instance, drinking a cup of V8 100% low-sodium vegetable juice is a quick and easy way to get a full cup of veggies. Tis the season to add color and flavor! Vegetable and tomato juice also are great additions to some recipes you?ll find in my cookbook, The All-Natural Diabetes Cookbook, like my memorable Minted Middle Eastern Meatballs and zippy Gazpacho Cocktail. Both are festive party foods.
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Plainfield, NJ: Looking forward to my first Thanksgiving since being diagnosed with t2 diabetes. I've been looking through our old standby recipes and am seeing a few things that seem very high in carbs, mostly the mashed and sweet potatoes, brown sugar and butter glaze on the carrots, and the PIE. Any suggestions on making that stuff more diabetes-friendly?
Jackie Newgent: The easiest way to approach your first Thanksgiving with diabetes is to simply fill up on lots of salad with light vinaigrette before the "feast." Then you'll be able to enjoy just small portions of the more calorie-laden goodies. But if you like the idea of that plateful of food at Thanksgiving, the American Diabetes Association has a good suggestion: fill half of your plate (anytime) with non-starchy vegetables, like green beans, bell peppers, mushrooms or carrots. You can easily do this by perhaps just changing one recipe instead of all of them. How about your carrots? They're still delicious without the glaze. Try simply steaming them and adding a bit more flavor with fresh dill. Want to opt for another or different veggie? If you have my cookbook, try the Haricot Verts Amandine recipe. And also remember, turkey is a lean protein source and you can go heavier on that, too. If you put that all together - a big salad, a plate filled with non-starchy veggies and lean turkey, then you?ll be able to even savor a perfect sliver of pumpkin pie! Enjoy!
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Cincinnati, OH: Sweet potato casserole (with the nuts, brown sugar and marshmallows) has been a staple of our Thanksgiving meal for years. This being the first year with the big 'D', I am wondering what I can serve in its place. Any suggestions/ideas would be welcome. Even if I use fresh yams, at 19g carbs per 1/2 cup it really doesn't seem worthwhile.
Jackie Newgent: Yes, that's a popular staple at so many Thanksgiving tables across the country. You can still make it, going a bit lighter on the brown sugar and marshmallows. And you can certainly enjoy it as is - if you just eat a very small portion and pass on the other starchy foods on the table. Keep in mind that if you really love sweet potato casserole, you only have it once or twice a year, and you plan for it, it might just be worthwhile! However, if you prefer, you might want to introduce a new staple in its place that all will be able to fully enjoy. Something I did a couple years ago was made a sweet potato soup recipe and served it in shot glasses as a Sweet Potato Soup Shooter. It was so fun, too! If you have my cookbook, you could even try that with one of the recipes, like the Carrot-Ginger Potage. (You could actually serve a regular helping of that recipe.) A good tip: soups can double as the "gravy" for holiday turkey! My Creamy Chestnut Soup is perfect for this.
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Richmond, VA: Hello! I am new to this Diabetes II thing... just diagnosed two weeks ago. So, my nutritionist said not to worry much during the family Thanksgiving meal, just watch portions more closely than I used to. Not really going to be much of a problem - I'm not a big meal eater... just one who eats the wrong stuff (we're working on changing that. Is that advice really good enough?
Jackie Newgent: Hello! Yes, that's good advice. I know it sounds very general, but it's still solid advice - especially since you-re not a "big meal eater." One tip you might find helpful is about 1/2 hour before the meal, have a small handful of nuts - or something that is satisfying to you. This will prevent you from being over-hungry at mealtime - which will help you think clearly (and think twice) about all of your choices rather than letting your eyes or nose make your food decisions. If you have a choice, try to make sure there are some steamed veggies, like green beans, available so you can build your meal around those?and the lean turkey, too.
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Kissimee, FL: Any good ideas about diabetes-friendly turkey stuffing? Gotta have stuffing!
Jackie Newgent: I wish I could tell you that there was a super-healthy way to make stuffing deliciously, but I haven't come up with a lovable winner just yet. However, here are some of the minor modifications to a stuffing recipe that I use which you might want to try: go heavier on the broth and lighter on the butter; if there's sausage, choose turkey sausage over pork sausage; choose whole grain bread rather than white bread or cornbread; go heavier on the veggies, like celery and onion; and don't forget the sage...that's the flavor that makes most stuffing so memorable. And when you add some fresh sage along with the ground sage, it'll help boost the flavor even more - especially if you're reducing the salt or fat.
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Las Vegas: Do you have recipes that won't make my son's blood glucose numbers spike? For example, I've noticed that organic pastas and snacks will not cause a huge spike, but rather his numbers stay even for the duration of his bolus (he's on a pump). I would like to find recipes where he can eat a lot of (healthy) carbs but not spend lots of time in the upper 200s or higher.
Jackie Newgent: Sure, there are plenty of recipes in my cookbook that should not cause a large spike in blood glucose - as long as eating the serving size indicated. For snacks, try the Mexicali Layer Dip or the Caribbean Black Bean Dip which both can be eaten with baked tortilla chips. For pastas, try the Jalapeno Whole Wheat Linguine Pesto with Poached Chicken and Sun-Dried Tomatoes. It's made with whole wheat linguine and balanced with plenty of other ingredients. Serve it as an entire meal - not an entrée; it has 3 starches and 4 lean meat Exchanges. But if unsure when trying a new recipe or a new carb-based food re: how your son?s blood glucose will respond, first serve an entrée as a side dish. Then increase the size from there. Try that with my recipe which uses soba noodles - they're made from buckwheat, which is a whole grain. It's the recipe for Asian Sesame Soba Noodle Bowl with Bell Peppers and Snow Peas. Hope you both like them all - and hope his blood glucose levels respond well, too.
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Citrus Heights, CA: I am one that loves vegetables. Fresh and/or cooked but not soft (crunchy good), grilled, baked. My question is about the mircowave oven. I often use the microwave to cook my veggies. Does this method take away any of the vitamins or minerals in the veggies? Usually just a little water in the bottom of a bowl with veggies and covered with a napkin. Thanks for your take.
Jackie Newgent: I'm so glad you're eating your veggies...that's the most important thing, of course! Not every nutrient responds the same and there are variations depending on the vegetable, but microwaving veggies tends to retain their nutrients relatively well. There's one study in the Journal of Food Quality that suggests microwave-steaming (which sounds like what you?re doing) retains nutrients the best in certain vegetables (like fresh broccoli or cauliflower and frozen corn or peas), followed by microwave-boiling, steaming and then boiling - in that order. So go ahead and zap your veggies!
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ADA Moderator : I'd like to take a moment to talk about your new cookbook. What is it's focus?
Jackie Newgent: The All-Natural Diabetes Cookbook focuses on creating fresh, flavorful, fuss-free dishes that will hopefully help people with diabetes, and anyone really, eat and live healthier every day. There are a variety of recipes, from main dishes to beverages, so you can enjoy eating better for any occasion. Specifically, it'll likely help you get your veggies in some of the tastiest, easiest, most clever ways. I hope you like it as much as I enjoyed creating all of the recipes for it.
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ADA Moderator : Why did you decide to write it?
Jackie Newgent: Well, my dad was diagnosed with diabetes and I wanted to help him and the millions of others living with diabetes make long-term dietary changes both that they can enjoy and that will improve their health. I couldn't find a cookbook out there like this so I decided to write my own.
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ADA Moderator: Do your recipes follow any guidelines?
Jackie Newgent: Yes, I follow guidelines consistent with recommendations from the American Diabetes Association, including making sure all the recipes in The All-Natural Diabetes Cookbook are low in saturated fat, have zero grams trans fat and offer health-protective nutrients. What I really hope people realize from this cookbook is that there are simple ways people with diabetes can eat healthier and live better--and enjoy it.
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ADA Moderator : What are some of your favorite recipes from the book?
Jackie Newgent: It's so hard to pick favorites! You might have heard the phrase some moms tell their kids: "I love you all equally, but differently." I guess I kind of feel the same way about my recipes. I love them all equally, but differently! They're all part of a long-term strategy to eating right - and enjoying eating right. For instance, I love my Minted Middle Eastern Meatballs. They have a really memorable flavor, they're nutritious and they're surprisingly easy to prepare. The "secret" to my meatballs' moistness and flavor is vegetable juice - it "sneaks" in some extra veggies, too. And since the holidays are around the corner, it's always best to have a couple different ready-to-go appetizers for parties or unexpected guests. Besides the meatballs, try my Curry Chicken Breast Salad with Red Grapes in Wonton Cups or White Bean 'n' Rosemary Bruschetta Bites. People will be begging you for the recipes!
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ADA Moderator: The cookbook sounds great Jackie. Let's get back to questions from the folks out there. From Spokane, Washington: I hear a lot about sugar, and the holidays are obviously full of it - from pies to cookies and candy - should I avoid anything with sugar?
Jackie Newgent: The good news is that avoidance of sugar is not necessary. However, when people with diabetes eat sugar-containing sweets, they need to do so sparingly - especially since many foods high in sugar only provide "empty calories" - meaning they don't provide significant amounts of important vitamins and minerals for the calories provided. As usual, the key is moderation. If you have diabetes, you can generally enjoy sweets in small amounts as long as they're part into your meal plan -- as you need to do for any other carb-containing food.
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Centennial, Colorado: I am confused about fiber. Does fiber "count" in the carbohydrate amount of a food? Some high-fiber cereals have a significant number of carbohydrate grams, but also have a lot of fiber. I understand that insoluble fiber is not absorbed. So, if counting carbohydrates, do you subtract the amount of insoluble fiber from the total? What about soluble fiber?
Jackie Newgent: I'm glad you asked this question! Some fiber, such as soluble fiber, is partially digested. But others such as insoluble fiber are not digested. Most labels contain only the amount of "dietary fiber" which includes both types. If a food contains more than 5 grams of fiber per serving, there is a good chance that much of it is insoluble. A good example of this is high-fiber bran cereals. The ADA recommends including ½ of the grams of fiber from the carbohydrate grams to get the total number of carbohydrate grams from a food.
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Fresno, California: I keep seeing Campbell Soup commercials touting sea salt as opposed to regular salt. We have been told we should limit salt intake. Isn't all salt the same?
Jackie Newgent: Teaspoon per teaspoon fine granulated sea salt and regular table salt will provide approximately the same amount of sodium - 2300 mg. However, there are a variety of different salts available to the food industry. For instance, in 2006 the Campbell Soup Company introduced new soup varieties made with a unique, lower sodium natural sea salt that allowed the company to reduce sodium content by 25-45 percent -- which enabled the company to still provide a tasty food that people expect. What's more, some salt connoisseurs tout the additional trace mineral benefit you may get from unrefined sea salt. Personally, I simply happen to prefer the flavor of sea salt - which is what I use for the recipes in my cookbook. I find that when I use flavorful ingredients, I don't need as much of them. So, pick a salt that you enjoy taste-wise. And keep in mind that no matter what type of salt you consume, it all needs to be included within your daily sodium allowance. The ADA recommends that all people with diabetes keep their sodium intake to less than 2,300 mg of sodium per day.
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Sevierville, TN: I'm newly diagnosed with Type 2 and need help with what I should eat at breakfast--eveything I look at seems so high in carbs! Currently, I have 1/2 med. banana, 1/2 C. Special K (with the dehydrated strawberries) 3/4 Soy milk, 4 oz. sugar/carb control yogurt, and 6 oz low sodium V-8 juice (vitamin pack, fish oil capsule, calcium pill and 2x500 mg. Metformin ER pills). I showed this to my PRN but she didn't say anything about it. I don't have insurance and can't afford to see a RD. Can you give me your comments on this breakfast? Thank you very much!!
Jackie Newgent: Without knowing your individualized needs, it's difficult for me to give you detailed advice. But it does seem that you're correct in saying that your breakfast may be slightly high in carbs - though it does seem to be nutritious. It's usually a good idea to aim for a balanced approach to a meal - getting carbs, a moderate amount of protein and a small amount of healthy fat, too. For instance, instead of the cereal, you might want to have a piece of lean meat, like lean ham, or even a small handful of nuts (sprinkle onto the yogurt, if you like). Or maybe spread peanut butter onto that banana half. For more information, do keep reading the information on this web site: http://www.diabetes.org. It's a wealth of helpful (free!) information on diabetes. There?s also a quick guide that might help you in better determining a healthful meal - it's on the site that's called "Rate Your Plate." Check it out at: http://diabetes.org/nutrition-and-recipes/nutrition/rate-your-plate.jsp.
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St. Augustine, Fl.: I still don't quite get the relationship between carbs, total carbs and sugar. One holiday treat I love is cranberry relish, made with real cranberries, orange, nuts and lots of sugar. Should I try this with Equal or Splenda or erase this from my holiday memories?
Jackie Newgent: My philosophy when it comes to making your favorite holiday foods more diabetes-friendly is to simply limit the portion size you eat instead of trying to concoct a less-than-memorable dish. Savor every bite of this petite portion slowly. And you can enjoy all the full flavors - especially if you only have the food once a year. Of course, it still needs to be incorporated into your meal plan to make sure you staying within a healthful total carbohydrate range. But if you want to make it a bit easier to include your cranberry relish recipe (and have a little bit more than a few bites), I suggest simply halving the added sugar. Surprisingly, you might even like it better since you'll be able to better enjoy all the natural flavors of the ingredients. Enjoy your holiday!
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Oceanside, CA: I bought this low effective carb and no sugar added chocolate bar at Traders Joe today, what is this? On the back it says that Malitiol, a sugar alcohol, has been omitted from the carb calculation because its conversion requires little or no insulin. Is this true. On the nutritional chart it states that it has the total carbs of 14g. and malitiol of 12g. so the net carbs are 2g. Is this information correct?
Jackie Newgent: Maltitol is a sugar alcohol. It is frequently used as a sugar-substitute in foods but is not a free food. It does contain calories - about 2 calories per gram. This is ½ the calories of table sugar or honey. The other thing is that sugar-alcohols can cause a laxative effect in some people, even with a small amount. Using the "net carb" calculation on a product is not a good idea when you have diabetes. Some of the sugar alcohol will cause blood glucose levels to rise. If you count carbohydrates, the ADA recommends counting ½ of the carbohydrate from sugar alcohols into your meal plan. If you eat foods with sugar alcohols, it's a good idea to check your blood sugar to see how it affects you. Another note on these types of foods. The chocolate bar will still be high in saturated fat, so you'll want to keep this as a special treat.
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Brooklyn, N.Y.: Would you be good enough to tell me if the following vegetables are okay for a person with diabetes: Butternut squash, pumpkin, sweet potatos. Also, what other vegetables are appropriate for a diabetic with gastroparesis? Thank you.
Jackie Newgent: Any vegetable is okay for a person with diabetes. However, the starchy vegetables that you mentioned have more carbohydrates in a serving than non-starchy varieties and need to be counted differently. Starchy vegetables should be counted as a starch or grain in your meal plan. For example, if you have sweet potatoes, that is the starch for your meal so you probably wouldn't want to also have rice or a roll. In general, the non-starchy veggies, like beets, spinach, carrots, zucchini and mushrooms, should be the focus of your meals. Due to the nature of this chat, I'm unable to provide you with specific advice for your gastroparesis. However, in general, people with gastroparesis should try to eat 6 smaller meals instead of 3 larger ones. This way, not as much food is in your stomach at one time. Liquids are usually easier to digest for someone with gastroparesis so don't forget you can get non-starchy vegetables in the form of low-sodium vegetable juice. Also, if you haven't already checked it out, you can find more information at http://www.diabetes.org/type-1-diabetes/Gastroparesis.jsp.
By the way, Im chatting with you today from Brooklyn!
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Sarasota, Florida: Hi. I have a rather complex medical history and find eating right for each condition seems to conflict with another. For instance, I have type 2 diabetes, and I know I need to eat more fresh fruit and vegetables and whole grains. However, I also have gastroparesis so I cannot eat raw vegetables, only cooked, and only those without skins or seeds. Fruits must be peeled and de-seeded as well. No whole grains, only processed foods. No nuts. No fiber since it slows digestion which is already slowed. Then I have lupus and arthritis and related autoimmune diseases. I'm very confused on how to put these diets together. Help!
Jackie Newgent: Trying to come up with a diet for all of these conditions may sound overwhelming. But I know that your diet can be managed - and can still be enjoyed. However, it really will take sitting down with a registered dietitian to put this all together for you. That's what we're trained to do - so you don't need to bear the burden of trying to figure this all out on your own. Unfortunately, without knowing your full history, only having a few minutes here, and due to the inability to provide medical nutrition therapy in this forum, I just am not able to give you the advice that you truly need. If you don't already have a dietitian, please ask your physician for a referral - or go to http://www.eatright.org and click on "Find a Nutrition Professional." You can also find Diabetes Education Programs at http://diabetes.org/education/edustate2.asp. I wish you the best.
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Vienna, VA : Parties seem to be my diet downfall - and between Thanksgiving and New Year's, there's no shortage of them. Can you share some thoughts on staying healthy with temptation right in front of me?
Jackie Newgent: Consider eating a snack before you go to a party as not to overindulge while you?re there. Also, at the buffet table, choose a "rainbow" of colorful, non-starchy vegetables like leafy greens, carrots, broccoli or tomatoes over some of the higher calorie, less nutritious options. Remember that even if it's a special occasion, your blood sugar doesn?t give you a "special occasion" break. So sticking with your individualized eating plan is important whatever day it is. Aim to enjoy your party, of course; just don't go for over-enjoyment. Another idea...if you're headed to a party where it's appropriate to bring something, take your own favorite party food that you know you can indulge in guilt-free. Try my Mexicali Layer Dip. It travels well and is always a popular party food. Hopefully you?ll get to eat some before everyone else does!
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Kaneohe, Hawaii: Aloha Jackie, I was wondering what is a good meal to eat pre/post, 5k/10k races. I do a lot of walks/runs often with a friend. I usually have a protein shake (Apex shake w/water) in the morning 2hrs or more before the race starts. I tend to get hungry before the race even starts.
What should I be eating pre and post race? Is it alright that I don't always have anything to eat after the race. Should I eat something right after a race?
Aloha, Eating Challenged
Jackie Newgent: Aloha! It's always best to determine your individualized eating plan that's based on your activity with a dietitian or diabetes educator who knows the specific history of how your blood sugar responds to your activity and pre/post meals. But here are some general rules of thumb. Pre-event meals should generally be eaten 2 hours (or a bit more) ahead of a race, just as you?re doing. That's good since you don't want to exercise on a full stomach--which can lead to indigestion, nausea and more. The ideal pre-exercise meal is primarily carbohydrates with moderate protein and little fat. You might need to have something other than or in addition to the protein shake that you?re already having. Then, hydration during exercise is key, of course. Post-exercise your food intake is especially important for various reasons, including recovery. A good idea is to try to eat a meal within the first 1/2 hour after a race - even if all you tolerate is a sports drink or energy bar. Then, it's usually a good idea to have a couple small meals after that -- 2 hours later and another 2 hours after that. Happy racing.
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ADA Moderator : The holiday season often means indulging in "spirits." Can folks have a glass of wine or two at a party? How should they approach alcohol in general?
Jackie Newgent: If your blood glucose levels are under good control, it's unlikely that a glass of wine or bottle of beer at mealtime will cause harm. The key is to drink in moderation, meaning one drink for women and two for men. Before you imbibe, check your meds. Some diabetes medications (as well as other meds) require limiting the use of alcohol. Also, if you use sulfonylureas or insulin, drink alcohol only with food since alcohol can affect blood glucose levels. Doing so will help to prevent a significant drop in blood sugar. And in any case, always seek the advice of your health care provider for the best way to incorporate alcoholic beverages into your individualized meal plan.
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ADA Moderator : Any recommendations on how to make some of my favorite recipes healthier?
Jackie Newgent: Evaluate ingredients to see if they could use a little nutrition improvement. I have several tips in my cookbook. For instance, in place of 1-cup sugar in baking, try 3/4 cup of sugar and add a pinch of a sweet spice, such as ground cinnamon, and/or an extra 1/4 tsp. vanilla extract. In place of 1 oz. baking chocolate, try 3 Tbsp. unsweetened cocoa powder plus 1 Tbsp. canola oil. There are plenty of ways to lower fat, sugar and carbohydrate counts in your favorite foods while still keeping the taste and texture you love.
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ADA Moderator : To try and stay "healthy" this holiday, any tricks/tips you can offer would be great!
Jackie Newgent: Sure! Find easy ways to fill up on nutrient-rich foods...so there will be less room for the rest. A good way to do that is to be big on veggies - whenever, wherever you can. Pile sandwiches high with cooked or raw veggies; use tomato/vegetable juice for preparation of whole wheat couscous or brown rice; fill up on raw veggies first at a holiday party; order a side of veggies for an appetizer when dining out; and be more liberal with herbs whenever it's an option?they count as veggies, too. When you're on the run, shopping till you drop, or traveling, makes sure to keep high-fiber, nutrient-rich snacks on hand - like a mixture of nuts, seeds and a sprinkling of dried fruit! (By the way...shopping is physical activity-that's part of a healthful lifestyle!)
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ADA Moderator : The holidays can be tough for everyone - any parting words of wisdom today Jackie?
Jackie Newgent: Here's a few tips that might help.
Tip 1: The holidays are a time to celebrate. So allow yourself to do that. Focus on the celebration of what you're thankful to have, including family and friends. The food is just a small part of that. But, of course, you can and should still enjoy festive foods, too. Just remember to view rich holiday foods as those to be savored in moderation while managing portions. Besides, there are many holiday foods that are quite nutritious. A holiday turkey breast is quite healthful, for one! If there's a buffet, peruse all the choices...then go heavy on the healthful foods and less on the rest.
Tip 2: Traveling can often derail healthful eating plans. If you're on the road or in the air this season, be prepared. Have foods and/or drinks on hand that are easy to consume no matter where you are, any time of day. Make a trail mix of your favorite nuts, seeds and sprinkling of dried fruit. Pack a small plastic bag of chopped red/green/yellow bell peppers. Throw a few cans of V8 100% low-sodium vegetable juice in to your tote or purse to help keep blood sugar levels steady and tide you over until your next meal without compromising on nutrition or taste.
Tip 3: Plan ahead. If you are going to a party at night, make sure to eat sensibly throughout the day so you won't be tempted to overindulge later on.
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ADA Moderator :
That's it for today. Thanks so much for taking the time to be here Jackie.
Thanks to all of you who joined us by asking great questions or by just tuning in. If you wish to continue any of today's discussions please feel free to visit the ADA Message Boards.
Keep up to date with all the ADA Live events and reference the archives here.
We hope you found this interesting and informative and that you'll join us again next time here at ADA Live. Our guests will be Rite Aid Pharmacists and Diabetes Care specialists at 1:00 p.m. EDT Thursday, December 6, 2007. See you then.
Jackie Newgent: Thank you Bob, and everyone who participated today. We did have some great questions and I hope that our discussion adds to the enjoyment that everyone feels at holiday time.
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