Planning meals help people with diabetes enjoy the holidays

Nov. 15, 2012 — A figurative mine field of savory dishes and desserts await many this holiday season, from pumpkin pies topped with whipped cream, green bean and mushroom casseroles, pork tamales, cranberries and cornbread dressing to fruit salads and oven-roasted turkey.

Harris Health System experts warn that while most will indulge in these tasty foods and some will gain weight, people with diabetes will need a plan to stay healthy.

Dr. Ashok Balasubramanyam, chief, Endocrinology, Harris Health Ben Taub Hospital, and Talar L. Glover, MS, RN, director, Diabetes Service Line and Patient Education, Harris Health System, say the strategy for people with diabetes is simple -- portion control, planning sensible meals and getting regular exercise.

"The rules for taking care of diabetes on a daily basis are straightforward," says Balasubramanyam, also a professor, Baylor College of Medicine. "Eat right, exercise, take your medicines and check your blood sugar. But following this every day, all the time, is hard. Everyone knows the rules, but the practice is difficult because you have to do it year-round for every meal, including holidays."

Symptoms of diabetes:

• Blurry vision

• Excessive thirst

• Fatigue

• Frequent urination

• Hunger

• Weight loss

Complications from diabetes:

• Heart disease

• Stroke

• High blood pressure

• Blindness

• Kidney disease

• Amputation of limbs

While people with diabetes face a challenge to stay healthy, they can still enjoy the abundance of tasty foods available during the holidays.

"There's nothing that you need to avoid eating," Glover says. "A small serving of pecan pie is fine, but don't overdo it. If you're going to have pecan pie, then you can't have cranberries and cornbread dressing and gravy and mashed potatoes and macaroni and cheese."

Because temptation is at every table, people with diabetes can't afford to indulge on a whim.

"You can't skip a meal to 'save up' to eat a big lunch or dinner if you've got diabetes," Glover adds. "You've got to know what's on the menu and try to spread your eating throughout the day. Don't try to eat it all in one sitting."

Normal fasting blood sugar ranges are between 70 and 99. However, even people who don't have diabetes may feel the effects of temporary high sugar levels. While tryptophan in turkey is usually blamed for post-holiday meal sleepiness, the real culprits are overeating and increases in sugar levels. A good way to avoid this is to take a walk or plan a physical activity after meals.

Balasubramanyam warns people with diabetes against upping prescribed medicine doses to compensate for food indiscretions. Because of the danger of potential side effects, any change in dosage should be carefully monitored by a physician. Only patients taking insulin who know how to adjust doses based on carbohydrate counting and "correction" factors should even consider adjusting insulin doses to cover overeating during the holidays, he adds.

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Eating fewer, larger meals may prove healthier for obese women

Dec. 6, 2012 — Media articles and nutritionists alike have perpetuated the idea that for healthy metabolisms individuals should consume small meals multiple times a day. However, new research conducted at the University of Missouri suggests all-day snacking might not be as beneficial as previously thought, especially for obese women.

"Our data suggests that, for obese women, eating fewer, bigger meals may be more advantageous metabolically compared to eating smaller, more frequent meals throughout the day," said the study's lead author, Tim Heden, a doctoral student in MU's Department of Nutrition and Exercise Physiology. "Eating larger meals less often lowered blood-fat levels. Over time, consistently eating fewer, larger meals each day could lower the women's blood-fat levels and thereby lower their risk of developing heart disease."

Heden and other MU researchers studied how meal frequency affected blood-sugar and blood-fat levels in eight obese women throughout two 12-hour periods on two separate days. All of the women consumed 1,500 calories. During the two different testing days, the participants consumed three 500-calorie liquid meals or six 250-calorie liquid meals. Throughout the 12-hour time frames, researchers tested sugar and fat levels in the women's blood every 30 minutes. Women who consumed three meals had significantly lower fat in their blood.

"The mass media and many health care practitioners often advocate eating several small meals throughout the day," Heden said. "However, when we examined the literature, we didn't find many studies examining or supporting this popular claim. This lack of research led to our study, which is one of the first to examine how meal frequency affects insulin and blood-fat levels in obese women during an entire day of eating."

More than one-third of Americans are obese, and these individuals are especially at risk for heart disease, the leading cause of death in the country, according to the Centers for Disease Control and Prevention. Heden says the research could help nutritionists and medical professionals develop strategies to improve the health of obese women.

"With multiple meals throughout the day, you have to be careful. If you start consuming several meals, there's more potential to overeat or to make unhealthy snack choices with easily accessible junk food," said Jill Kanaley, professor in the Department of Nutrition and Exercise Physiology and study co-author. "Some people are good at making efforts to eat healthy snacks; however, most people aren't, and they end up taking in too many calories. The more times you sit down to eat, the more calories you're probably going to take in."

Obese women would benefit from consuming three balanced meals a day, Heden and Kanaley agree.

The study, "Meal Frequency Differentially Alters postprandial Triacylglycerol and Insulin Concentrations in Obese Women," will be published in the journal Obesity.

The Department of Nutrition and Exercise Physiology is jointly administered by MU's College of Agriculture, Food and Natural Resources, College of Human Environmental Sciences and School of Medicine.

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Journal Reference:

Timothy D. Heden, Ying Liu, Lauren J. Sims, Adam T. Whaley-Connell, Anand Chockalingam, Kevin C. Dellsperger, Jill A. Kanaley. Meal Frequency Differentially Alters Postprandial Triacylglycerol and Insulin Concentrations in Obese Women. Obesity, 2012; DOI: 10.1038/oby.2012.171

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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