Fresh Focus

The holidays can be a whirlwind, even if this year with just a small household group. After the dust settles and the dishes are washed, it can feel like such a crash of adrenaline. After hours of cooking over the holidays, you probably don’t want to cook for the rest of the week. We’ve all found ourselves in that boat a time or two.  Thankfully, when you open up the fridge all you see are leftovers!

Eating out of your normal routine during the holidays can make individuals with diabetes feel uneasy after seeing a change in their blood sugars. It’s understandable to find yourself feeling this way. However, the key to getting blood sugars back on track is to focus on the basics. There is absolutely no need to do a fast, fad diet, or to sit around and binge on leftovers. Basically, don’t throw in the towel on your nutrition just because the “new year” is right around the corner. 

Remember the Basics

There are many ways to utilize a post-holiday Healthy Plate Method for getting things back on track and to eat up those leftovers. Fill one quarter of the plate with protein, the other quarter with grain and starches. That leaves half of your plate to load up with colorful, high fiber, lower carbohydrate vegetables. Add olives, nus, seeds, coconut oil and other fats to your completed plate. Individuals with Diabetes pay more attention to the carbohydrate portions (exchanges) of the plate, which have the biggest impact on blood sugars.

A favorite post-holiday leftover meals is “fancy grilled cheese”. It’s about 45 grams of carbohydrates and I’m betting you have a few of the ingredients on hand. All you need is leftover turkey, cranberry sauce, a mild cheese of your choice, and bread. Our house is a big sourdough bread and provolone, mozzarella, or Havarti cheeses, but you can choose whichever options you love.

While your skillet (or grill) is heating up, put butter on the outsides of each slice of bread.  Place the turkey, cheese, and cranberry sauce inside and close up the sandwich.  Grill both sides just like you would a traditional grilled cheese sandwich.  Once your bread is toasted it is ready to eat!  Dip your leftover raw veggies in some hummus or an olive oil based salad dressing.  Now your healthy plate meal is complete. 

Consistency is the Best Strategy

The truth is you can enjoy foods with carbohydrate as long as you are mindful of portions.  It is important to be as consistent as possible in your intake, especially if you are on a set medication or insulin routine. Certain diabetes medications such as Glipizide, or rapid acting insulin, like Novolog work quickly.  If you do not eat carbohydrates when you take them, you may end up with hypoglycemia, or low blood sugar levels. Being consistent with your carbohydrate intake can help prevent the rollercoaster of blood sugar levels (when you have highs and lows). 

Whew, you are back from the grocery store and your countertop is full! Now, what to do with all the food you just purchased? Episode 17 of the Fresh Focus Podcast dives into meal prepping and give tips on how to be successful with the process during the upcoming holidays.

Remember when you get home from the grocery store, try to get the prep-work already done so you can simply open the fridge and enjoy your produce throughout the week. 

Here are some tips on produce as you put away those groceries. 

·         Several items like potatoes, bananas, and tomatoes need to be kept cool, and dry, but not in the fridge. 

·         Mushrooms should only be washed right before use. 

·         Apples should actually be stored in the fridge. If left at room temperature, they will soften ten times faster. 

·         Carrots like the fridge and seem to do better when peeled right before use. Berries are the same way. 

Freezing fruits and vegetables is quick and easy, plus the colder temperature helps to preserve the produce at its peak maturity and maintain nutritional quality. There are a few foods not recommended for freezing. These would be lettuce greens, eggplant, potatoes, radishes, and sprouts. 

Bananas are delicious but quick to ripen. A solution is to peel and freeze overripe bananas in a clean Ziplock bag. The frozen bananas can then be used later in baking or in a yummy fruit smoothie. Papaya and mangoes work well this same way. Remember that fruits are naturally sweet and do contain carbohydrates. 

As you put all the groceries away, grab one of those handy fruits or veggies and think about the meal possibilities for the holidays. Perhaps you have already been thinking about what to take to Aunt Betsy’s this year, or maybe you are expected to prepare the same dish every holiday as it is requested by the entire family. 

Tune in to this episode as we put a Fresh Focus on some holiday meal ideas or recipes that you could prepare and know that you WILL have lower carbohydrate options on that buffet at Aunt Betsy’s home this year.

What if we told you that smart grocery shopping actually starts before you leave the house? And this year you may not even need to leave the house.  On-line shopping is a great option for anyone who has small children, is pressed for time, or has health concerns. 

Important steps in making a shopping list: 

·         Start by checking over your menu and preparing a list ingredients and food items you need, including amounts.

·         Second, take an inventory of what you have on hand.

·         Keep pantry items such as dried or canned beans, spit peas and lentils, canned vegetables with no salt added, canned fruit in 100% fruit juice, nut butters, tuna, salmon and sardines on hand.

·         Whole grains such as brown rice, quinoa, oats, and whole-wheat pasta can also be included in a healthy meal plan and are essentials in the pantry.  

·         Consider stocking your freezer with non-starchy vegetables such as broccoli, riced cauliflower, carrots and Brussels sprouts, and don’t forget the fruit such as berries and cherries.

Shopping from a list whether online or in the store will help you to avoid unhealthy impulse purchases saving you time and money. It’s also a good idea to go grocery shopping after a meal or snack. It’ll be easier to stick to your list and can reduce your risk of having a low blood sugar if you are doing more walking than usual. 

When reading food labels, pay attention to the Total Carbohydrate per serving not just the amount of sugar when you are shopping for someone with Diabetes. It’s always a great idea for the whole family to look for foods with the fewest ingredients, and ingredients that you can pronounce.

Tune in to episode 16 of the Fresh Focus Podcast for some suggestions about what to place in your cart, and ways to have a more successful shopping experience. 

It’s been a whirlwind of a year and whether you live alone or are continuing to practice social distancing, the holidays are going to look a little different this year. Whatever this year’s holiday season brings, you can certainly scale it down while still enjoying some of those traditional favorites in a smaller group. 

Pair down the meal with these tips:   

Protein: Unless the protein source is breaded or fried, it will not raise your blood sugars.  If it is breaded and fried, then allow for about 10-15 grams of carbohydrate for that particular portion of the meal. This year, a small turkey or even a whole chicken is a good option.  If cooking is not your strong point, then purchasing a rotisserie chicken from your grocery store deli is an excellent option.  

Starches: Some of the traditional holiday starches include potatoes and the stuffing/dressing. Potatoes are also a good option as they are a good source of vitamins, minerals and fiber, so we’re going to acquire more nutritional benefits than the stuffing. Whether you prefer regular or sweet potatoes, you can dice them up, place in a pan or casserole dish, toss in olive oil and sprinkle with sea salt. They can be roasted in the oven at 400 degrees for about 25-45 min.  

Remember, it’s the extras such as the condiments, sauces, gravies, etc. that we forget to count as part of the total carbohydrate intake for a meal and the result is a high blood sugar reading after that particular meal.  

Vegetables: Filling half your plate with vegetables that are low in calories, high in fiber. Fiber is not only good for our heart and digestive system, but it can also help with blood glucose control. A popular holiday vegetable dish is green bean casserole. While this dish isn’t too terribly labor-intensive and can be made in smaller quantities, it does require some preparation and cooking time. Although the green beans themselves are a non-starchy vegetable and therefore very low in carbohydrates, the mushroom soup and fried onions will add some carbs to that dish. 

A paired down version would look more like frozen or canned green beans with butter or olive oil, sea salt and pepper. Other fall vegetables include brussels sprouts, carrots, parsnips, cauliflower, and acorn squash. If purchasing the fresh versions of these veggies, they can be roasted in the oven. If purchasing frozen or canned versions of these veggies, then less preparation is needed as they can be warmed or steamed on the stove or in the microwave. 

For persons with diabetes, scaling down could potentially make the mealtime more simplified and less stressful in the sense of timing of the meal as well as knowing how to count the carbohydrates in the meal. Listen into episode 15 of the Fresh Focus Podcast for more holiday menu tips. 

Are you hosting a holiday meal or party this year? Don’t get overwhelmed! Our Marion VA Health Care System Diabetes Educators are able to assist in the meal planning if your guests include people with diabetes in episode 14 of the Fresh Focus Podcast. 

Just remember no one food or beverage is necessarily excluded for someone with diabetes.  It is important to balance between starchy foods like stuffing and yams and non-starchy vegetables such as green beans, asparagus, broccoli. And to be mindful of alcohol intake.  

Meals or appetizers can easily incorporate dietary needs without distracting any flavor, but find out more tips as a host one what the best strategy for creating a diabetic-friendly gathering!

Key holiday hosting tips:

1.       Hosting for the holidays for people with diabetes doesn’t have to be overwhelming. Plan the menu with a balance between starchy foods like stuffing and yams with non-starchy vegetables like broccoli or green beans.

2.      Allow guests to dress and sauce their own food. This helps those who are counting their carbohydrates which might impact their insulin injections.  

3.      Alcohol consumption can interfere with blood sugar as well as the hormones needed to maintain healthy blood sugar levels. 

4.      In your pre-party preparation, you might get some fruit juice or regular soda to have on hand in the event someone may experience a hypoglycemia (or low blood sugar).

5.      A vegetable tray or appetizers such as cheese, apples, or black bean dip will provide healthy options for individuals with Diabetes to keep blood sugar stable while waiting on the holiday meal. 

6.      Focus on keeping things simple and cost efficient to have a smooth, successful party. 

Remember the holidays are meant to represent the spirit of giving, understanding, and compassion, and there’s nothing that better signifies these principles than being aware of all guests needs.

The holidays can be a magical time, but how often do you get excited and then when they roll around fears about your health start to creep into your head?  If you are a person with Diabetes you might also worry about controlling blood sugars. These are completely common thoughts, but the holidays don’t have to be a time for throwing in the towel on all the hard work you’ve done the rest of the year. 

Season three of the Fresh Focus Podcast was created by Marion VA Healthcare System Diabetes Educators to help you tackle the holidays of 2020! We understand it is a challenging one, and there are new modifications this year that will include smaller gatherings for 2-6 people. This year, instead of making a large turkey, you might find yourself utilizing an herb roasted turkey breast instead. The same way you could try mini pumpkin pie-lets for a change to reduce the overall calories and carbs while still getting your pie fix.   

For people with Diabetes, when you choose to eat all of your calories and carbohydrates at one meal you are taking a chance of having hypoglycemia or low blood sugar during the day. Then there is a possibility to have hyperglycemia or high blood sugar after eating too much that night with one large meal. Take a listen while Kerri goes through these key points in controlling that type of blood sugar roller coaster!  

1.       Eat consistently and not skip meals during to prevent overeating at that holiday meal due to not eating the rest of the day.

2.       Remember to always take your medications as ordered.

3.      Utilize the healthy plate method even on the holidays to help fill your plate with all those good foods. Bring a delicious holiday inspired salad to the meal for a pop of green and bright red at the meal.   

Congratulations! You have just delivered your adorable baby! Now you are faced with the decision on breastfeeding vs. formula-feeding. There can be a lot of pressure to do one or the other. I think new moms don’t necessarily expect the opinions that come with making that choice. Just remember a fed baby is best, no matter your planned choice of feeding. 

Although breastfeeding and nursing are often described as “natural,” it might not feel that way for everyone.  For some it comes very easy, “like riding a bike,” but for others it is a struggle. Maybe the baby doesn’t latch well, you have a low milk supply, your nipples are super sore, you don’t have much support in the home, you have a demanding job, or there are medical issues that make breastfeeding more difficult. Remember, even breastfeeding moms who seem to have it all together, often find it difficult and overwhelming at some point or another.  

What if breastfeeding or pumping doesn’t work out or you are only able to breastfeed for a short period of time? It happens, and it happens to the best of us. It is a great accomplishment to provide your baby with even a little bit of breast milk even for a few weeks or days. Think of breast milk like a vitamin supplement, small amounts can give a boost of nutrition.  Even if your baby only gets an ounce or a few drops a day it can still be beneficial to their health.  

This episode of Fresh Focus shares several different stories and struggles of our Registered Dietitians. It also discusses benefits of breastfeeding, history of formula, seeking help from a lactation counselor, and provides encouragement no matter what path you choose to feed your baby.

The key point to remember is everyone’s journey is different. Sometimes what we anticipate, plan for, or expect is not possible or turns into a different path entirely. Whichever route you choose or need, whether it is breastmilk, formula, or a combination, your baby will flourish. Seek advice when you need it, but remember, do what is best for you and your family. 

 
Host Bio:  Melaina Lane, MS, RD, LDN, CDCES is a Registered Dietitian Nutritionist and Certified Diabetes Educator serving veterans enrolled in the Home Based Primary Care program within the Marion VA Healthcare System. She received her Bachelor’s and Master’s Degree from Southern Illinois University in Carbondale, Illinois. Melaina has worked for the VA the past 9 years. Prior to coming to the VA, Melaina taught nutrition at a local community college, worked in the acute care setting at two nearby hospitals, and has provided menu review for several local senior citizen facilities since graduating. Melaina also published a children’s book following the birth of her first child. She enjoys long distance biking, time spent on the water, and home interior design. Melaina feels very blessed to work with our nations heroes each day and provide the care they deserve for all the contributions made to our country. 

Breastfeeding can be an awesome bonding experience with your baby.  Although it provides baby with great nutrition, it can be overwhelming, frustrating, and brings up many questions for mamas and their support systems. 

Eating healthy does not affect the quality of nutrients in your breast milk, but it is important for new moms to eat healthy to maintain energy levels (hello lack of sleep from midnight feedings).  In order to take the best care of your baby, you have to take care of yourself as well, which includes eating a well-balanced diet.  Check out our previous series on the Healthy Plate Method for balanced diet tips.

Many moms find themselves worrying about producing adequate milk for their baby. So often, how to increase supply is a common question. Below are three tips to help with establishing and maintaining a good milk supply.  If you are concerned with your supply try these tips while looking for a lactation consultant in your area for a one on one appointment to discuss your specific situation.

1. Initiate breastfeeding early.  The sooner the better after delivery getting baby to latch will help signal to your body that it needs to start milk production!  

2. Frequent nursing sessions based on baby’s hunger cues.  Breastfeeding is all about supply and demand.  The more often and consistently you nurse or pump to empty your breasts signals your body to make milk in order to replace what has been used.

3. Try to manage and reduce stress.  There is A LOT going on in those first few weeks of a baby’s life and lots of those things can increase stress!  Managing stress is so important because being over stressed can affect the letdown reflex and poor letdowns could affect your milk supply. 

The old saying “the days are long but the years are short” is completely true for pregnancy and breastfeeding.  Even though you feel all 24 hours in the day, at some point your nursing journey will come to an end.  Listen in on this podcast episode as Dietitian Lauren Hocking interviews Caitlin, a nursing mom of two for her advice.

Host Bio: Lauren Hocking, RDN, CD is Registered Dietitian Nutritionist serving veterans out of the Vincennes, Indiana CBOC within the Marion VA Healthcare System.  She received her Bachelor’s Degree in Human Nutrition and Dietetics at Southern Illinois University Carbondale and went on to complete her Dietetic Internship at the Memphis VA Medical Center in Memphis, TN.  She has been at the VA  8 years where she covers PACT clinics at Vincennes in addition to Home Based Primary Care. She assists our nation’s heroes make strides toward living a healthier life by helping them make lifestyle changes by taking it one step at a time.