Beat the blood sugar rush this Christmas with a little forward planning, says dietitian Helen Gibbs.
Many people look forward to summer as a time of sun, sea, salads and more physical activity. Healthy holidays in other words. But many of my patients are also worried the opposite will happen, that they lack the willpower to turn down the extra food and drink on offer during the festive period and their hard work losing weight or achieving blood sugar goals during the year will be quickly undone.
Many people with diabetes say they lack willpower to stick to a diet. Personally I don’t believe in the idea of willpower any more than I believe in dieting. Instead I recommend my patients use three simple tools to help keep their blood glucose under control during the holiday season: advance planning, reducing temptation and limiting opportunity, as the following real life examples show.
HŌNE’S PARTY PLAN
One of my type 2 clients, Hōne, who had lost 10kg and stopped his glipizide (diabetes medication), was having a pre-Christmas review. He told me: “I am planning to have treats only at Christmas parties”. I asked how many parties. He said 14 – all before Christmas Day! We agreed he needed to change his plan.
Quite a few of the parties were “bring-a-plate” events based around children’s activities. After some discussion Hōne decided to:
• Have a healthy snack before a bring-a-plate event so he was less hungry.
• Bring a healthy plate to share.
• Be the designated driver for the grown up parties, and bring some diet soft drinks in the car in case there wasn’t anything suitable when he got there.
• Try to eat a ½ plate of salads, ¼ plate starchy food and ¼ plate of meat at the buffet or BBQ table.
Hōne also decided to increase his physical activity to offset the extra food and drink over the holiday season. He walked every day in the morning and went swimming with the grandchildren at least twice a week when he and his wife were providing holiday care.
We both agreed not to worry about Christmas Day so Hōne could just enjoy it.
When I saw Hōne in the New Year he was pretty pleased with himself. He had managed to stick to the rules for 11 of 14 parties, and his weight had dropped 1kg – instead of going up 6kg which is what he feared.
Karen was angry when she came to see me with her husband Jeff. She wanted a diet sheet for him to follow over Christmas to keep him on the straight and narrow. It turned out that Jeff, who has type 2 diabetes, was in the habit of eating sweets and chocolate treats that were left out for the grandchildren when they were visiting between Christmas and 6 January.
I asked why the sweets were there in the first place, and this opened up a whole different perspective on the problem. Karen felt the children would get bored and stop coming to visit them unless they got treats. But their 6-year-old grandson had just had three fillings, and she felt bad about that.
Armed with this information we set some joint goals:
• No sweets in bowls for grazing.
• One small treat for everyone once a day. These were to be kept out of the way until treat time.
• Karen wouldn’t buy any extra “just-in-case” treats.
Then we addressed the issue of making grandparent time more fun.
Karen and Jeff decided to use the extra money from not purchasing treats to buy several active play toys (ball, hula hoop and elastics), and teach the kids to play some old-fashioned ball games.
They would also encourage all the kids to have better oral hygiene by having a star chart for teeth brushing after each meal. The reward was a trip to the movies.
MOANA’S HARD CHOICE
The best way to avoid overeating is to make high fat and high sugar foods less visible and accessible.
In our house, for example, we have freezer cookies that we bake when needed, such as when we have visitors coming, so there aren’t lots of biscuits lying around begging to be eaten.
Sometimes you can’t control the food you will be offered over the holiday season. Moana, who has prediabetes, came to me asking for advice on how to manage the annual summer week-long event at her parents’ farm.
“We set up tents and eat and drink ourselves silly. Last year I tried to talk about making some changes, and I ended up crying because my sisters got really angry with me. Mum had a toe amputation earlier this year because of her diabetes, but she really doesn’t care and she has told me to not make any fuss.”
As we explored it, she realised she didn’t need to go for the whole time and opted to go for a single weekend. This is a fairly extreme solution but in this case it was her best option.