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How to eat well and enjoy Christmas food when you have type 2 diabetes

When you're managing type 2 diabetes, it's possible to eat healthily while still enjoying a lot of the delicious, festive food on offer over the Christmas season.

Type 2 diabetes and Christmas

If you have type 2 diabetes, you'll be aware that following a healthy diet is one of the most effective ways of managing your diabetes and reducing the risk of developing complications, including cardiovascular disease, blindness, amputation, kidney disease and depression. Maintaining this over Christmas day - as well as the festive celebrations that fill December - can feel daunting.

While it's true that many Christmas treats are high in sugar, refined carbs, saturated fats and salt, there's plenty of healthy festive food. By managing your portions and finding a balance between treating yourself and restraint, you can still enjoy your food this Christmas. Azmina Govindji, registered dietician and member of the Diabetes Research and Wellness Foundation (DRWF) editorial advisory board, champions realistic goal setting over deprivation during the festive period:

"Trying to lose weight during the holidays is likely to be a self-defeating goal. Instead, strive to maintain your weight. Depriving yourself of festive foods or feeling guilty when you do have them isn't part of an empowering healthy eating strategy."

According to the National Institute for Health and Care Excellence (NICE), people with type 2 diabetes need to consider the best times to eat, how many carbohydrates to have per meal, and reducing their alcohol intake. Your healthcare team should help to create the best diet plan for your needs.

Christmas food to avoid or limit with type 2 diabetes

Starchy and sugary carbs

When it comes to managing your diabetes over Christmas, knowing which festive treats greatly impact your blood glucose (sugar) management is a good place to start. Carbohydrates - both starchy and sugary - can cause your blood glucose to rise. These foods contain a surprisingly large amount of sugar.

This is particularly true of 'refined' carbs, like white bread/flour/sugar, which can be found in many Christmas canapes like mince pies, breaded chicken, and sausage rolls.

Food that's high in salt

You'll also need to limit food that's high in salt. Too much salt can raise your blood pressure and increase your risk of heart disease and stroke. The charity Action on Salt warns that a Christmas dinner can contain over 15 grams (g) of salt - over twice the recommended daily maximum of 5-6 g.

Checking food labels, as well as limiting your consumption of shop-bought processed foods, can significantly reduce your salt intake. Some top Christmas culprits include crisps, sausage stuffing, salted peanuts, and shop-bought gravy.

Food that's high in fat

It's also important to maintain a healthy weight if you are living with type 2 diabetes, as research shows that health risks are increased if you are living with obesity or overweight. A key factor in avoiding weight gain is limiting your intake of fatty foods, especially saturated fats and trans fatty acids. These can raise your blood glucose, your cholesterol and your blood pressure.

Saturated fats can be found in dairy foods like cheese, cream and full fat milk, as well as fatty, processed meats like bacon and sausages. Trans fats are sometimes present in highly processed treats like cakes, biscuits, pastries, crackers and takeaways.

Healthy Christmas food to embrace

While it's true that you need to manage your intake of many festive favourites carefully with type 2 diabetes, there's plenty of Christmas food that's healthy and delicious: "Perhaps surprisingly, many traditional Christmas treats are nutritious foods, moderate in calories and rich in health-promoting vitamins, minerals and phytonutrients," says Govindji.

Foods that are high in fibre and protein, and also contain low-glycaemic-index sources of carbohydrate - such as fruit, vegetables, whole grains and pulses - are recommended by NICE for managing type 2 diabetes. Research has shown that this diet can keep blood glucose, cholesterol, and blood pressure at healthier levels which in turn reduces the risk of associated conditions.

Govindji argues that Christmas day could even be the perfect opportunity to reach your five portions of fruit and vegetables a day without having to try. The DRWF monthly newsletter 'Diabetes Wellness News' is a useful source of information for people managing diabetes, and here Govindji has highlighted several popular Christmas foods:

  • Roast turkey - rich in protein and low in fat.
  • Smoked salmon - high-protein, low-fat and rich in cardio-protective omega-3 fatty acids (exercise moderation due to high salt content).
  • Potatoes - source of vitamin C and other nutrients (roast in spray oil rather than butter or fat to reduce saturated fats).
  • Carrots - source of vitamins and fibre.
  • Brussels sprouts - source of vitamins and fibre.
  • Unsalted nuts - source of unsaturated oils, fibre and the antioxidant vitamin E.
  • Satsumas - source of vitamins.
  • Christmas pudding - source of iron, fibre, and potassium (although moderation is key as this is also high in added sugars and saturated fat).

Diabetes UK also provides resources to help you plan a healthier Christmas, including several festive, healthy recipes.

Other tactics to help you eat well at Christmas

Knowing what Christmas food to embrace and what to limit will empower you to make healthier choices throughout the festive season. Being mindful of portion sizes is also important for avoiding weight gain.

Other tactics can make your Christmas diet goals more effective and easier to maintain. Remember, it's OK to enjoy the odd high-calorie treat. Following these rules can help you to stay in control:

  • Stick to smaller portions.
  • Eat slowly and chew more - a proven technique that helps you to feel fuller.
  • Balance out any less healthy eating by eating better at other times.
  • Fill up most of your plate with healthier options, like vegetables.
  • Consider healthy alternatives - such as natural yoghurt instead of double cream.
  • Enjoy every bite - it's OK to enjoy yourself at Christmas, and a little indulgence can help you to stick to your long-term diet goals.

Tips for eating out over Christmas

You may find yourself attending a few Christmas dinners with friends, family, or work colleagues over December. Eating out can limit your control over what you eat and can offer temptation.

Diabetes UK has practical advice to help you choose healthier options:

  • Before attending, check if the restaurant provides nutritional information online - you can plan ahead and learn which options are healthier.
  • Be the first to order - to avoid being swayed by other people's choices.
  • Consider ordering a starter as a main meal if you have a smaller appetite.
  • Order meals that are high in protein (such as lean meat, egg, fish, or beans).
  • Only order dessert after you've eaten your main meal - you may find you're too full for one.
  • If your meal is delayed, and your blood glucose levels are in danger of dropping too low, ask if there is a bread roll to tide you over.
  • If possible, add extra vegetables to your plate - filling up on vegetables is a low-calorie, nutritious option.

Type 2 diabetes, Christmas, and alcohol

There is usually an abundance of alcohol at Christmas celebrations, and everyone should be wary not to succeed the recommended limit of 14 units per week. If you have type 2 diabetes, you can usually enjoy drinking in moderation; however, you need to be extra cautious.

If you treat your diabetes with medications such as insulin or sulfonylureas, you'll be aware that alcohol interferes with your blood glucose levels and can make you more likely to have a 'hypo' (hypoglycaemia) when your blood glucose drops too low. Alcohol reduces your liver's ability to store glucose, halting recovery when your blood glucose is dropping.

If you enjoy a drink at Christmas, opt for drinks that have lower sugar levels. Alcoholic drinks with high sugar content include:

  • Liqueurs (cream liqueurs like Baileys are also high in fat).
  • Cocktails made with fruit juice.
  • Sweet wines.
  • Sugary spirit mixers such as fizzy drinks.
  • Sherries.
  • Beers, ales, and ciders (contain carbs which will increase your blood glucose levels initially).

Diabetes UK advises caution with low-sugar beers and cider - sometimes called 'diabetic drinks'. While they have less sugar, there's often a higher alcohol content. On the other hand, low-alcohol wines often have more sugar and should also be consumed with caution.

If you do enjoy a drink during the festive season, you can better manage your blood glucose by following these recommendations:

  • Stick to spirits, dry wines, and Prosecco (they're lower in carbs and sugar).
  • Use spirit mixers (such as tonic water) with no added sugar.
  • Don't drink on an empty stomach.
  • Have a pint of water before bed.
  • Eat breakfast the following day and check your blood glucose levels if you have a meter - your risk of having a hypo can last up to 24 hours after drinking.
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