Diabetes is an imperfect disease, and it does not care how perfect you try to be.
Even when an individual does ‘all the right things’ to manage their blood sugar levels, their blood sugar may still be out of range. The unpredictability of diabetes means that what worked one day to keep blood sugar levels balanced may not work as successfully as the next day. This can be incredibly frustrating and frankly unfair. But it’s a reality that many people with diabetes face.
When someone expects perfection with diabetes, it can harm both their blood sugar management and mental health. When one is not able to meet their goals, whether it is an HgA1c under 7 or increasing your time in the appropriate range, it can lead to diabetes burnout (where the individual becomes overwhelmed and disengaged from their diabetes care). It can also lead to an increased stress response, increased anxiety, disordered eating, eating disorders, and much more.
So, what is the solution?
It’s not about giving up or settling for less. It’s about finding a healthier, more sustainable approach to managing your diabetes. We just need to shift the approach and set realistic expectations for our health. It’s a journey, but it’s one that’s worth taking.
Practicing and cultivating self-compassion will be vital to reducing perfectionism.
Accepting that your blood sugar levels may not be ideally in range and that managing diabetes can be challenging is a beautiful first step in removing and reducing the pressure to be perfect. Be kind to yourself; you’re doing the best you can!
Diabetes providers and specialists typically encourage individuals to achieve and maintain certain health goals. For example, one may be told to keep an HbA1c below 7 consistently. As practitioners, we must learn to lead compassionately and distinguish between “optimal vs. dangerous management of blood sugar levels.” Practicing with compassion and focusing on optimizing blood sugar levels includes setting personalized goals and considering all aspects of one’s health.
Here are some examples of how one can focus on other aspects of one’s health to help with diabetes management.
Sleep helps regulate the hormones controlling blood sugar and metabolism. The body’s ability to control blood glucose levels is impacted if one struggles with sleep. For example, when one does not sleep enough, the body may produce less insulin, making it harder to balance blood sugar levels. Providers can work with clients to establish good sleep hygiene, aid blood sugar control, and provide many other benefits.
Stress can impact blood sugar levels. Stress hormones, including cortisol, may prevent the pancreas from producing enough insulin and cause blood sugar levels to rise or fall unpredictably. Providers can work with clients to establish self-care and stress management routines. These skills will not only help with blood sugar control but also have many other benefits for the client’s daily life.
Ultimately, the goals above are examples that give you a basis for what realistic and reasonable goals can look like. I recommend speaking with your specialist to formulate some that feel the best to you!
Even with diligent management, blood sugar levels are difficult to keep stable. Expecting perfection in managing diabetes can lead to adverse mental health outcomes, including anxiety and a condition known as ‘diabetes burnout.’
The solution lies not in striving for perfection but in adopting a healthier, sustainable approach with realistic health expectations. This empowers individuals with diabetes, their families, and healthcare practitioners to take control of their health in a way that is manageable and sustainable.
Resources to read more about diabetes and perfectionism:
As the leaves start to turn and the crisp air calls us indoors, it’s the perfect time to embrace fall with some wholesome recipes that nourish the body and the soul. This season offers an array of fresh produce, from hearty squash to vibrant root vegetables brimming with flavor and nutrition.
In this post, I will share some ideas for delicious recipes that celebrate this season, making it easy to enjoy without compromising wellness. Let’s dive into some warming soups, colorful bowls, and delightful dishes to keep you cozy through the chilly months!
Add a handful of steamed kale in the base of a bowl. Combine cooked quinoa with roasted vegetables such as butternut squash, beets, and broccoli. For added protein, top with some seasoned chickpeas and drizzle with a tahini vinaigrette.
Add to a crockpot ground turkey (raw), diced peppers, onions, tomato sauce, canned diced tomatoes, kidney beans, black beans, and chili seasoning. Cook for 6-8 hours on low and layer on your favorite toppings (cilantro, jalapenos, Greek yogurt, etc).
In a large pot, add sauteed onion, garlic, vegetable stock, uncooked wild rice, mushrooms, carrots, celery, sweet potatoes, and a bay leaf. Season with Old Bay and stir to combine. Bring soup to a simmer, reduce heat to medium-low, and cover for 30-40 minutes. Stir in coconut milk and kale for added creaminess and texture.
Assemble roasted sweet potatoes, greens, rotisserie chicken, diced apples, goat cheese, pumpkin seeds, and dried cranberries in a bowl. Pair with a zesty orange vinaigrette for a flavor and antioxidant boost.
Add to a large pot sauteed carrots, onions, garlic, and chicken broth. Bring to a simmer and add whole wheat orzo. Cook for a few minutes, then stir in the chicken and freshly squeezed lemons. Finish by stirring in spinach and herbs of your choice.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8512783/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782012/
https://health.clevelandclinic.org/benefits-of-squash
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8626194/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221300/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213178/
https://dpi.wi.gov/sites/default/files/imce/school-nutrition/pdf/fact-sheet-sweet-potato.pdf
https://www.mountsinai.org/health-library/supplement/quercetin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475924/
https://bonavita.co/blogs/know-your-food/pumpkin-seed-facts?srsltid=AfmBOoq5zQA96_EnisgYijoCs9emAiD4ewhWlxbMeOrOCeWYvF-s2hK0
https://www.rickysinghmd.com/in-the-news/the-great-debate-over-white-meat-and-dark-meat/
https://draxe.com/nutrition/bone-broth-benefits/
Have an ongoing conversation with your body. It may often feel like your body is speaking a foreign language, it sure did for me when I first started tuning in! However, the more you listen and reflect on how your lifestyle choices leave you feeling, the more you build up your toolbox to help optimize the way you feel.
For example, when you’re feeling tired, it’s unlikely that your body is saying, “I need caffeine,” but it may be saying, “I need water,” “I would benefit from some fresh air and/or movement, “That was a big meal, my blood sugar is a bit wonky,” “I need to prioritize sleep tonight,” etc.
Light triggers cortisol, darkness triggers melatonin. Makes sense…yet, most of us are on electronics up until bedtime (and often in bed!), with the light from our electronics telling our body it’s daytime, therefore negatively impacting our quality of sleep.
Sleep is when the body heals and repairs, so it should be a priority. Winding down is also important, which is where blue light-blocking (BLB) glasses enter the picture!
Putting blue light-blocking glasses on when the sun sets (or at least one hour before bed) helps support circadian rhythms. It decreases the negative impact electronics have on cortisol and melatonin levels.
Expert Tip: rather than reaching for a melatonin supplement, aim to support your body’s production of melatonin.
Blood sugar levels impact inflammation, energy, cognition, and more, and because inflammation is the root of many disease states, balancing blood sugar is key for disease management and prevention.
Whenever you consume carbohydrates, aim to balance them with protein, quality fat, and nonstarchy vegetables to promote blood sugar values that resemble speed bumps rather than mountains and valleys.
For example: rather than consuming a piece of fruit (carb) on its own, pair that piece of fruit with a handful of nuts or seeds (quality fat)
Slow down when you eat. Digestion begins in the mouth, and chewing is key. If we bypass step one of digestion, the results aren’t as favorable. Remain mindful of slowing your eating speed and chewing thoroughly to ensure you support digestion rather than stressing out your digestive system.
Expert tip: experiment with using a smaller utensil so each bite is naturally smaller. Keeping a visual (i.e. Sticky note) or tactical (i.e. Trinket of some sort) reminder where you eat can also help.
Many of us live in a state of fight or flight for much of the day. Fight or flight is used to describe the sympathetic nervous system, whereas rest and digest is used to describe the parasympathetic nervous system. Simply taking an intentional deep breath, inhaling through the nose, and having a prolonged exhalation through the mouth are simple and readily available tools to activate the parasympathetic nervous system.
Expert tip: rather than focusing on ways to remove stressors (which is often unrealistic), arm yourself with tools to support stress resilience. Taking a deep breath at various times throughout the day is a powerful way to calm your nervous system.
Summer is right around the corner!! It’s almost time for pool parties, celebrations, picnics, BBQs and fun in the sun! While many of us may read that line and feel excitement for what’s to come, many of you may also sense some nerves and feelings of being overwhelmed. Warm weather months often bring up many worries around food and body image for those in eating disorder recovery. I’m here to give you some tips for how to not only survive, but most importantly, have fun during these months!
Depending on where you’re personally at in recovery, structure is often helpful during these months, especially if your school or work schedule is changing. If your days become wide open when the summer months hit, it may be helpful to develop a routine to ensure you’re staying on track with your recovery goals. Sometimes it’s helpful to think about what your day will look like, and then you can envision when you’ll eat around your schedule. For example, if you are going to the beach with your friends at 11am do you need to pack lunch? Snacks? Hydration?
Clothing has such a huge impact on how we feel about ourselves and our bodies. If you have time before the summer months hit, it might be helpful to work with your team to build a plan to go through even some of your summer clothes before the season fully hits. It can be hard to get dressed in the summer when you haven’t gone through your clothes in a year. There can be a lot of uncertainty about how stuff feels on your skin or what fits. Once you have a better feel for your closet, you’re only grabbing for what is your current style, what fits, and what is comfortable! Though it won’t take all of the stress away around summer clothes, it sure does help some! Remember – clothes are meant to fit you, not vice versa!
When I think of the summer, my mind is filled with endless gatherings and celebrations, many of which have a cookout or food involved in some way. Use your therapy and dietitian sessions to plan for these events! It can be helpful to even role play certain comments or scenarios that could take place. You can work with your team to best determine if a lot of planning is needed, or if the challenge will be to engage in less planning in your stage of recovery. Remember to include topics about body image when planning with your team, too.
Often during the summer months our schedules open a bit more, especially if we’re on break from school. Lean into this increased flexibility if you could use more support. Chat with your team to determine if meals with your team, food exposures, body image groups, or other means of support would be beneficial for you during this break from your usual schedule.
I always think this can be a fun way to navigate a new season. Develop the list without the idea of changing your body or engaging in eating disorder behaviors. What do you want to remember about your summer next year? Is there anything you want to push yourself to do this summer? Here are some ideas that come to mind for me. What’s on your list?
While summer can be a hard time for individuals working on eating disorder recovery, it’s important to remember that it is possible! Continue to lean into your “why” for recovery during these months and use your treatment team to celebrate your wins and discuss your challenges. I hope these tips help you to have a fun summer you’ll never forget!
We all know it can be difficult to thrive in a cold climate like Chicago during the winter months. We do choose to live here for a reason, right? (even if you’re currently questioning that reason!). The good news is that your winter months can improve with some intentional support. Here are five tips from a dietitian for navigating the winter blues:
Low Vitamin D levels have been shown to contribute to Seasonal Affective Disorder (often known as S.A.D). The importance of sunshine for health is two-fold: it signals to our bodies that we are awake and helps to reset our circadian rhythms to allow for better sleep, and in the warmer months, it allows for absorption of the sunshine vitamin – Vitamin D.
Research shows that in the winter months (around October through April), one cannot make and absorb enough Vitamin D from the sun. This is because the sun’s UVB rays, which are required for Vitamin D synthesis in the skin, are weaker. As a dietitian, I usually recommend a food-first approach over supplements. However, getting the daily suggested amount of vitamin D from food alone can take effort. The highest food sources are fatty fish (like salmon, sardines, and tuna), liver, cod liver oil, egg yolks, and irradiated mushrooms. If these are not common in your diet, supplementation is recommended.
Most people do well with 1000-2000 IU of Vitamin D3 (rather than D2) daily throughout the winter months. I recommend checking that all your supplements are third-party verified (with a USP or NSF label) to ensure the product contains what it says it contains and is without harmful contaminants. Always check with your doctor first before starting.
Get outside for at least 15 minutes during the daytime to get some sunlight. Getting outside during the daylight hours has proven benefits for mood and sleep. If you cannot get outside, consider light therapy – this involves exposure to bright light through a light box, which mimics the effects of sunlight and can, therefore, have the same mood-boosting benefits. These are increasingly available these days – consider asking your therapist or doctor for recommendations for affordable and effective options.
Focus on eating sources of omega-3 fatty acids, such as fatty fish (see above), for their mood-altering benefits (if you are vegan, consider a good quality algae supplement with omega-3s). Aim for about 12 ounces/week of fatty fish to reap the benefits of these omega-3 fats. For sustained energy levels throughout the day, focus on foods with fiber, unsaturated fats, and lean proteins, such as whole grains, fruits, vegetables, nuts/seeds, legumes/beans, avocados, dairy, and eggs.
Keep warm with hot drinks and hot food! Enjoy hot cocoa, tea, and hot soups and stews.
It can be challenging to keep a good routine with shorter days, but going to bed and waking up at the same time can be instrumental in managing the winter blues. Practice good sleep hygiene by maintaining a relaxing bedtime routine – try taking a warm bath or shower, practicing yoga or stretching, and avoiding electronic devices for at least 30 minutes (preferably closer to an hour) before bed.
Similarly, stick with a morning routine to get up simultaneously every day. If you are having difficulties waking up, try moving your phone across the room so you have to get up when the alarm goes off, or if you will just bring your phone back to bed with you (guilty!), consider an alarm clock that slowly wakes you up with gradual light, mimicking a sunrise, before the alarm goes off.
As mentioned above, try to get out during the daylight hours. Finally, consider a regular movement routine – whether it’s walking on the treadmill, biking, yoga, weightlifting, or group exercise classes – getting your blood flowing and your heart pumping will lead to mood-boosting endorphins and help you to feel tired at night to reinforce your bedtime.
While it can be incredibly tempting to cancel plans when feeling down, it is even more essential to seek out and commit to regular plans with friends or family who you know tend to boost your mood. Try to stick with these commitments, even if it’s just for a short time, at least once a week. You will likely thank yourself once you get there and begin to engage in social connections with your loved ones.
If the above are not enough to get you out of the winter funk, you are not alone. You may be experiencing a more significant seasonal depression (S.A.D). If this is the case, it is important to seek further support from a therapist, psychiatrist, or both. You may benefit from CBT (Cognitive Behavioral Therapy) or medications that have been proven to help with S.A.D., such as SSRIs or SNRIs (which help to boost the good mood chemicals in your brain). There is no shame in needing extra support.
References:
https://www.sabinorecovery.com/how-to-help-seasonal-depression/
https://www.nytimes.com/2022/12/06/well/live/vitamin-d-deficiency-winter.html
Around 20% of Americans suffer from chronic digestive issues, and many do not seek help until it gets bad enough to disrupt daily life. Digestive issues can come and go, with seemingly no rhyme or reason, making it difficult to identify patterns independently.
According to the American Gastroenterological Association, it is common for those with digestive issues to avoid talking about their symptoms unless their provider brings it up. This is troubling when you consider that around 40% of Americans with chronic digestive distress have had to stop or reduce daily activities (such as exercise, errands, or social time) due to the extent of their discomfort.
As a dietitian and a long-term sufferer of digestive issues, I can personally relate to how difficult it can be to both endure the symptoms and to talk about it. If this is you, too, let me tell you how a dietitian can be supportive in working with you on digestive concerns:
First, while working with your dietitian, it is important to see a Gastroenterologist (GI) doctor to rule out more serious causes of digestive issues:
Irritable Bowel Disease (IBD) is an autoimmune disease that targets the digestive tract, with two subtypes – Crohn’s Disease and Ulcerative Colitis.
They lead to inflammation and irritation of different parts of the digestive tract, causing diarrhea and poor absorption of nutrients. If left untreated, this can lead to permanent damage to the intestines and a higher risk of intestinal and colon cancers.
Celiac Disease (CD) is an autoimmune disease that causes damage to the intestines with the ingestion of gluten, the main protein in wheat, barley, and rye. Over time, untreated CD can lead to malnutrition and weight loss and an increased risk of other autoimmune diseases, intestinal cancers, and heart disease.
Small Intestinal Bacterial Overgrowth (SIBO) is when the small intestine has an abnormal amount of bacteria present, leading to malabsorption of nutrients, damage to the intestinal lining, and possibly weight loss or malnutrition. It is normal for the large intestine (the colon) to have many bacteria, but not the small intestine.
Infections of the GI from SIBO
Infections of the GI tract can be bacterial, viral, or parasitic. These typically require treatment with medication and cannot be fixed through dietary changes.
Common SIBO testing
Common testing to rule out the above diagnoses includes a Hydrogen Breath Test (SIBO), stool sample (infections), upper endoscopy or small bowel endoscopy (imaging and biopsies of the esophagus, stomach, and small intestine), colonoscopy (imaging and biopsies of the lower small intestines, colon, and rectum). Your doctor will determine which are most essential based on your symptoms.
Although more common in children than adults (only about 4% of adults have them), they are still essential to rule out due to the potential severity. A food allergy occurs when your body perceives the proteins in a specific food as a (false) threat, therefore launching an immune response against them. It is possible to suddenly develop an allergy to a food you’ve long tolerated.
The only way to diagnose one is to work with an allergist. They can perform skin-prick and/or blood tests to indicate whether food-specific immunoglobulin E (IgE) antibodies are present in your blood.
Food intolerances are different than an allergy because they do not involve the immune system. They have similar (but often less severe) symptoms to food allergies – digestive concerns (cramping, nausea, bloating) and others such as headaches or skin rashes. There is currently no valid testing for diagnosing food intolerances, despite many companies now offering “food sensitivity” testing. These blood tests target IgG, a food–specific protein; its presence in the blood is likely a normal response of the immune system to food exposure, and higher levels may be due to tolerance of foods, not the other way around.
If your doctor rules out the above, they may diagnose you with Irritable Bowel Syndrome (IBS). This is a functional disorder of the digestive tract, classified by its cluster of symptoms rather than a physical abnormality of the digestive tract. It has three subtypes – IBS-C (constipation), IBS-D (diarrhea), and IBS-M (mixed subtype). While it does not cause an increased risk for cancer over time, it can lead to serious distress and affect the quality of everyday life, with symptoms such as urgent bowel movements, watery stools, blood in the stools, chronic constipation, bloating, and abdominal pain.
Gut issues are complex. There are often many causes, and therefore, a multifaceted solution is needed during the process of working with a GI doctor, and after, your dietitian can support you in navigating your diet and lifestyle. A dietitian will look at all aspects of your health – nutrition of course, but also sleep, stress, physical activity, potential food intolerances and triggers, supplements/medications, etc.
For instance, if your dietitian identifies that your diet is lacking in essential nutrients (such as healthy fats, fruits, and vegetables, etc.), they can explain what is missing, where to get these nutrients, and how to grocery shop for and cook these foods in an enjoyable way.
A dietitian can also help differentiate conflicting information on the internet for treating digestive concerns because symptom management for these issues is not always the same. For example, while a high-fiber diet can improve constipation, it may worsen or trigger symptoms of diarrhea. A dietitian can help you find the right balance of fiber and other nutrients for your specific condition.
Many people believe that food sensitieves or intolerances are the causes of their digestive issues, and this is true in a small percentage of cases. However, for most, their overall pattern of eating and lifestyle habits tend to matter more. For instance, a client with IBS-D may have persistent diarrhea that worsens with trigger foods when they are in a flare-up, but they may be able to tolerate some of those trigger foods when they are not in a flare-up.
When food intolerances are present, a dietitian can help you identify them over time with detailed food recalls, targeted elimination, and, more importantly, reintroduction of foods. The goal is to eliminate as little as possible from your diet over time. Why? Because food variety is one of the keys to long-term gut health!
A dietitian can help you target this list specifically to your needs, but here are a few essentials for building up your gut-health overtime:
Fiber* is in plant foods, including fruits, vegetables, whole grains, and beans/legumes. It is known as a pre-biotic in the digestive health world, which acts as fuel for the abundant bacteria in your colon. When they are well-fed, the healthy bacteria in your colon can thrive. Research shows that variety in plant foods – different colors, types, and ways of eating them – is the most beneficial for gut health.
*If you have chronic diarrhea, your dietitian can help you navigate the amount and types of fiber you consume. For instance, many folks with chronic diarrhea tolerate cooking better than raw vegetables.
There is a strong connection between your brain and the gut, which is mediated by the bundle of Vagus nerves. These are the main nerves of your parasympathetic nervous system. This system controls body functions such as digestion, heart rate, and your immune system. If you are chronically anxious or stressed, your brain will send these messages to your gut, which can cause disruptive symptoms. Likewise, if your gut health is poor, it can affect your mental state.
Work with your dietitian to discuss techniques for managing stress, including yoga, meditation, and work-life balance, and ask for a referral to a therapist or psychiatrist if needed.
We have no good way of knowing what specific probiotics (or healthy bacteria) are needed for overall gut health. Therefore, I do not often recommend probiotic supplements to my clients – it’s essentially a “shot in the dark” and can be more expensive than helpful. Instead, getting probiotics from various food sources may be more beneficial. They are abundant in yogurt and fermented foods such as kefir, kimchi, cabbage, and more.
Focus on water, tea, and coffee (<400mg/day, or <4 cups) to improve your gut health. Try to reduce alcohol (1 drink a day for cis-woman, 2 drinks a day for cis-men, and avoid/reduce binge drinking – which is 4-5 drinks in one sitting) or abstain from it if needed.
Movement helps with stress management, and digestion (especially for constipation), and works to reduce the body’s overall inflammation.
References:
https://www.verywellhealth.com/how-to-get-tested-for-sibo-4125868
https://www.crohnscolitisfoundation.org/what-is-ibd/ibs-vs-ibd
https://celiac.org/about-celiac-disease/what-is-celiac-disease/
https://acaai.org/allergies/allergic-conditions/food/
https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/igg-food-test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682924/
https://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance
It is understandable why people turn to weight loss as a resolution in the New Year. In our weight-focused society, there is endless pressure to be a smaller size. If you’ve heard our practice philosophy at Healthier Tomorrows, you know we promote a weight-neutral, non-diet approach to health.
This means we help our clients focus on health-promoting behaviors rather than try to change the number on the scale. Weight is not a behavior; it doesn’t always change when you adopt more health-promoting habits!
Picture this: you have been adding fruits and vegetables to meals and starting a walking routine. You are noticing improved energy, mood, and digestion. Then you step on the scale – the number is higher than two weeks before you started these habits. What happens next? If you’ve been here before, you know the answer: you feel discouraged. You may skip your walk the next day or stop cooking as much. See what is happening here? Focusing on the ever-elusive lower weight makes it hard to stick with these long-term goals.
What if this year could be different? If you’re interested in setting non-weight focused health-aligned resolutions, here are six recommendations from a dietitian:
Many of my clients have goals to cook at home more often – not just for health, but for budgeting, too – eating at home more often can help you save significantly on food costs. From a nutrition perspective, cooking at home allows you to add more nutrition, whether tossing an extra handful of spinach into the soup, adding a side of roasted vegetables or a salad to meals, or snacking on more crunchy vegetables and fruits.
All other health goals can suffer without proper sleep. Good sleep provides the energy to care for ourselves, get in touch with hunger/fullness cues, and deal better with life’s stressors. The National Sleep Foundation recommends sleeping 7-9 hours a night. Consider discussing a nightly wind-down routine with your dietitian or therapist, investing in a good sleep mask and noise machine, and ensuring your bedroom is cool (around 65-68 degrees). Avoid screens at least 30 minutes before lying down.
Taking care of your physical and mental health are equally important. Having routine yearly checkups with your doctor allows you to monitor your health status and practice disease prevention. Keeping up with your therapist and/or psychiatrist regularly is essential for your mental health and managing stress levels.
Your dietitian can help you set and achieve health-promoting habits to make you feel better in the short term, reduce your disease risk in the long term, and heal your relationship with food. Important note: if you’ve had problems with weight-biased medical care in the past, ask a trusted provider for a referral to a HAES-aligned physician or provider.
I’m sure this isn’t the first time you’ve heard this suggestion – easier said than done, right? Being on our phones too much (especially on social media) can lead to enhanced body dissatisfaction and exacerbate stress or low mood. Like any other habit you’d want to reduce, try replacing some screen time with another habit, preferably one that provides joy or relaxation!
You could replace 30 minutes of screen time each night with 30 minutes of reading, talking on the phone with a loved one, cuddling your pet, or stretching. Reducing screen time can allow you to be more present, less stressed, and sleep better over time.
We know staying hydrated is important for health, but how much fluid do you really need in a day? According to the National Academy of Medicine, 9-13 cups, or 72-104 ounces, is the daily recommendation for the average adult, with variation among individuals. For instance, those who are regularly active, living in hot climates, pregnant or breastfeeding, etc., will need more.
In the short term, even small amounts of dehydration can cause fatigue, mood changes, and difficulty concentrating. Long-term, it may contribute to constipation, UTIs, and kidney stones.
Fun fact: it is a myth that caffeine dehydrates you, at least in moderate amounts. Research shows that up to 180mg (or ~2 small cups) of coffee/day won’t cause you to urinate much more than usual.
Therefore, tea and coffee (in modest amounts) can contribute to hydration! Alcohol is dehydrating, though, so make sure to consume water alongside it and/or reduce or avoid alcohol intake if you are able.
In our consumer culture, keeping up with the latest fashion trends, home décor items, and more can be tempting. However, clutter in the home can cause stress (along with a dwindling bank account).
Consider investing in experiences more often than material items – for instance, planning a trip or weekend getaway, seeing your favorite artist in concert, or learning a new skill (such as a pottery or cooking class). If you need budget-friendly experiences, consider reading or a picnic in a park on a nice day, walking through a nature preserve, watching a movie marathon with a friend, or enjoying live music at a bar or restaurant.
These experiences may be more likely to contribute to your overall well-being and happiness in the long run versus material items that will lose their value (and your interest in them) over time.
Resources:
The Sleep Foundation. Effects of Sleep Deprivation. https://www.sleepfoundation.org/sleep-deprivation/effects-of-sleep-deprivation#:~:text=Long%2Dterm%20sleep%20deprivation%20can,get%20the%20rest%20they%20need. Access 12/4/2023.
The National Academy of Sciences. Dietary References Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. https://www.nap.edu/read/10925/chapter/6#102. Accessed 12/1/2023.
As a dietitian, I believe that feeling well can and should extend into the holiday season. While it is a lovely time for many reasons, it can also put us out of our normal routine, making it difficult to prioritize ourselves physically and emotionally.
This year, I challenge you to abandon an all-or-nothing holiday approach. You can enjoy rest from exercise while also fitting in some time for joyful movement to avoid feeling sluggish. Similarly, you can enjoy fun foods without stress and guilt, while also intentionally adding some fiber and protein to support energy and digestion. Your priorities may change depending on the plan that day. The following are a few tips for feeling your best this season– take from them what resonates with you!
I bet most dietitians would agree with me on this one- it is difficult to eat mindfully and enjoy your food (and to stay sane around your quirky relatives) if you are not eating enough. Holiday meals can be larger than usual and occur at odd hours of the day, but this isn’t an excuse to skip meals. Eating regularly allows for blood sugar stability, which results in more even moods and energy levels.
If your holiday meal is at midday, treat it like lunch. If it’s midafternoon, treat it like an early dinner. Yes, that means I still recommend eating your regular meals and snacks surrounding the holiday meal. And yes, they can be leftovers from the meal itself!
While the holidays can be fun and joyous, they can also be stressful, with numerous plans and commitments. It’s important to set boundaries with your time and energy. For instance, if you know you max out your ability to socialize with family after 10 hours, set boundaries ahead of time on when you need to leave.
It may also be helpful to step away for a moment –bundle up and take a walk, offer to run an errand, or call a friend. This may involve having a go-to support person to contact if the conversation starts to get stressful with political dialogue or worse, your relative’s dieting plans for the new year.
Sleep is especially important when the rest of your normal routine is out of whack. Along with regular eating, getting adequate sleep (7-9 hours a night) allows you to feel more stable in mood, get better in touch with hunger/fullness cues, and manage your emotions when faced with a lot of social time. You could also consider naps as an opportunity to rest or take a social break – turn on a movie and have a quick snooze.
Staying hydrated is important for feeling well during the holidays. When we travel, eat different foods, and are off our normal routines, our digestion can be affected. Staying hydrated is one way to keep things regular. It also can keep energy levels and mood stable.
I recommend bringing a reusable water bottle along to holiday celebrations, especially if traveling. Along these lines, consider being mindful of alcohol. This could look like an intention to drink a glass of water in between alcoholic beverages, to limit the total intake of alcohol, or to take breaks/days off from alcohol intake altogether.
One of the trickiest parts of the holidays can be how, all of a sudden, everyone you know – from the coworker you sit next to at the office to your great aunt who you haven’t seen in a year – is talking about their upcoming diet for the new year.
There can also be more subtle comments about being “so bad” for getting that second slice of pie or unsolicited advice about food, your body, or how you look. Whatever it may be, you have options:
“It sounds like you’re feeling happy about that choice. Anyway, did you watch the new season of [insert tv show]? What did you think about…”
“It makes me uncomfortable when you comment about my food choices (and/or body). Let’s talk about something else.”
“My food choices don’t reflect on my moral value or worth. Getting seconds of mashed potatoes is morally neutral.”
Happy holidays! Enjoy the people you love and your favorite foods!
The holidays are an exciting time of year. Still, for many of us living with a chronic disease like type 1 diabetes, the holidays can add even more stress and decision-making to our already chaotic lives. Did you know that people living with type 1 diabetes make an additional 180 decisions a day on average?!
Added stress for those with diabetes could be from dealing with the insensitive food comments others make about sugar-causing diabetes, which isn’t true. A person with diabetes may have to navigate how to handle comments others make about what the person with diabetes should or shouldn’t be eating since they have diabetes.
For example, “You have diabetes, so you shouldn’t be eating Christmas cookies.” Some people with diabetes may have their well-meaning family or friends make sugar-free alternatives that the person with diabetes may or may not have asked for. Yes, people with diabetes can have the “regular versions” of foods and keep their blood sugar stable. It depends on the person with diabetes and their preferences!
On top of the food comments and special versions of foods being made, changes in our sleep, eating, movement routines, increased travel, and eating different or new foods can make carb counting tricky. All these factors can cause it to be challenging to enjoy ourselves, keep up with regular routines, and manage blood sugars.
As a dietitian living with type 1 diabetes, here are some of my tips for navigating diabetes during the holidays.
Nourish yourself all day. I don’t recommend “saving up” for the big meal. Eating consistently throughout the day will help keep your blood sugar, energy, and mood stable.
Enjoy the food! If your favorite dish is being served, have some, and take home some leftovers! You can incorporate your favorite dessert into breakfast or a snack the next day by having the dessert with Greek yogurt, your favorite nut butter, chia or flaxseeds, fruit, etc. Also, you can just enjoy the leftovers by themselves!
Eat dessert with your meal. This is not a requirement, but if you have the option, it may benefit your blood sugars to have dessert with your meal because the protein and fiber from your meal may help stabilize the carbohydrates in the dessert.
If you have the capacity, educate others about diabetes. This could be like explaining how your diabetes technology works or challenging diabetes stigma by providing education.
Connect with friends with diabetes, “diabuddies,” in person, online, or share with those in your life who are open to listening. Diabetes can be isolating. You don’t have to deal with it all on your own!
Practice self-care. Self-care can look like having low-blood sugar snacks on hand, designating time for rest, staying hydrated, practicing saying no, and having boundaries. No one can do it all!
Go easy on yourself. It is okay if your blood sugar isn’t perfect. The holidays can be a busy and emotionally challenging time of year. Try to give yourself grace and be present.
One of my missions as a dietitian is to simplify food decisions and to reduce shame around not always wanting to cook. Most of my clients live busy, robust lives with many obligations and hobbies, and time or desire to cook can become deprioritized.
Instead of beating yourself up or relying on expensive takeout, it can be helpful to use other tools at your disposal, like meal delivery services. While they are more expensive than cooking, compared to frequent takeout, you can save money in the long run.
Here are a few meal delivery services I recommend to my clients* and some highlights of each. All involve prepared meals ready to heat, serve, and deliver to Chicago.
Territory Foods’s registered dietitians work with local chefs and restaurants to craft healthy meals within your dietary restrictions. All meals are dairy and gluten-free and contain no refined sugars, nitrates, chemical preservatives, or artificial colors.
Balanced meals that include all food groups. Creative, colorful meals with variety. Entrees (mostly lunch and dinner) and individual meal components – e.g., “family style” grilled chicken breast, roasted broccoli, or roasted sweet potatoes.
All meals are dairy and gluten-free; some vegetarian/vegan options.
MyoMeals is based out of Chicago and only delivers to the Chicagoland area. They offer healthy, affordable meals featuring ingredients mainly sourced from local Chicago vendors. They believe meals created with macronutrients in mind lead to more nutritious meals and provide this information on each meal. MyoMeals also incorporates an assorted menu with international dishes.
Balanced meals that include all food groups at a reasonable price point. Both classic and more unique options are available.
-Entrees (including breakfast, lunch, and dinner)
MyoMeals doesn’t mention meals for dietary intolerances or restrictions. Limited vegetarian options; no information on allergens or intolerances exists, but ingredients are listed.
Chef-owned Chicago-based meal delivery company offering ”delicious, mindfully-prepared meals throughout the Chicagoland area.”. KitchFix’s chefs and nutritionists create a rotating variety of healthy, unique meals for various diets. KitchFix partners, donates, and volunteers with many local charity organizations.
Fun fact! During graduate school, I worked at their storefront in the Gold Coast (which has since closed – they now operate 100% online). I can vouch for how delicious their meals are!
Balanced meals that include all food groups. Unique, colorful meals with variety. Entrees include (breakfast, lunch, and dinner), and individual meal components – e.g., grilled chicken breast, sweet potato wedges, or herbed salmon, and dessert options (e.g., brownie bites).
Kitchfix Caters to dietary intolerances or preferences: all meals are dairy and gluten-free, although only a few vegan/vegetarian options are available. Meals are non-GMO, gluten-free, dairy-free, peanut-free, and refined sugar-free.
Veestro Meals is the best option for vegetarians and vegans, as all meals are plant-based. They create meals using fresh ingredients and are chef-prepared. Meal options list all ingredients and nutritional information.
All plant-based (vegetarian or vegan) meals. A variety of delicious and creative options. Regular entrees (mostly lunch and dinner) are available, and individual meal components – e.g., roasted broccoli, potato wedges, buffalo cauliflower- and dessert options (e.g., fudgy brownies and chocolate chip cookies).
Veestro Meals offers plant-based (vegetarian or vegan) meals. The website doesn’t mention other dietary restrictions or allergies.
If you’re looking for a culinary-focused meal delivery service, CookUnity is an outstanding option. It boasts a roster of over seventy chefs, including Food Network alums and James Beard award winners. They use modified atmosphere packaging technology, allowing fresh meals to last longer in the fridge. CookUnity is sustainability-focused and launched a returnable packaging program in NY and LA to reduce waste.
Balanced, tasty-looking meals made by local chefs. Each meal has a rating (out of 5 stars), so you can see which meals other customers have preferred—regular entrees (breakfast, lunch, and dinner) with many options.
Able to filter by vegetarian, gluten-free, etc., or specific ingredients needing avoidance.
If you are recovering from disordered eating, please note that most of these websites and meals contain calorie and macro information, and if this is triggering for you, please consider avoiding it.
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