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We Americans hinge our gatherings around food. Food is a cornerstone of any major holiday, party, or get together. And the height of all of the holidays that center on or around food is none other than Thanksgiving. Thanksgiving is and forever tied to our public awareness and memory to traditions centered on what we consume.

But what of the members of our families that may have a new or relatively recent diagnosis of type two diabetes? With all of these savory foods prepared for a crowd, how do we also prepare something that is healthy for those in our gathering diagnosed with diabetes restrictive to partake of, while still making it tasty for the whole group? We asked Ashley Littleton, registered dietitian at Memorial Hospital of Converse County that very question.

"I often like to say because food is love for so many people, and there's a lot of really staunchly held traditions typically revolving around food, that holidays are hard to navigate," said Littleton with a warm smile. "So, one of the ways that I like to focus, especially when people are going to other people's houses, I encourage those people with diabetes to be a person that brings maybe the not such a decadent food item."

What kinds of items can you bring to offset some of the more savory and tempting items on the table? "Maybe a vegetable tray with some hummus or a dip that is more nut based, or even bean based. You can even make your own hummus' that doesn't have additives or preservatives," suggested Littleton. Also keeping in mind the meal before the meal, "you have that [vegetable tray] available as a snack option, it makes it a lot easier to avoid maybe some of the other things that aren't so great for us."

For people with type two diabetes, overloading on carbohydrates in particular and in one meal, especially one that can range upwards of 1,000-2,000 calories by estimates can spell trouble. Littleton recommends "If you have a favorite dish, to try to alter it some way, that maybe there's a little less carbohydrate containing part of the meal. So if we're making all of these items that are high in refined carbohydrates maybe you alter your green bean casserole for just a fresh green bean that is sautéed in oil or just steamed, or even roasted."

Roasted vegetables are becoming a more significant trend in kitchens in the last few years. And Ashley recommends them as a healthier alternative to some of the richer stylings that appear more habitually on Thanksgiving tables. Another suggestion is paring down on those portions. "For example, If your aunt Sue makes an amazing stuffed acorn squashed something-something, whatever," laughed Littleton. "Just having that taste, but trying to fill yourself up on the things that you know are better for you, and hopefully that's something that you brought with you."

Another concern is eating far too much throughout the day. "Because you're not going to get away from the tradition completely, and that's okay to have a few bites of some things," Ashley continued. "We have Thanksgiving hungry and Thanksgiving full, and avoiding getting that Thanksgiving full, and just eating until we're satisfied. Then, your day doesn't have to derail you completely."

Another idea could mean merely eating a healthy and filling breakfast the day of versus saving up all of the room in your stomach for the main event. "Try to get a full healthy type of breakfast: some eggs, fruit, maybe some yogurt and some nuts. Something a little more sustainable." But also with this recommendation, and particularly if you're a house guest this Thanksgiving, "maybe not necessarily something along the lines of dessert style breakfasts. Having a small piece of it, but instead of maybe having your entire plate of overnight French toast for breakfast, making sure to get some eggs in and some healthy proteins, and getting in some fruit that has some fiber that's going to hold you over into the meal."

Often as Americans, our traditions at Thanksgiving are food based, and while that's great to have familial traditions, creating alternate traditions that aren't food specific can go a long way to keeping you from continuously grazing, getting too full, or derailing your diet. Instead of watching football have a tag or flag football game in the yard, take a walk after you eat to get your food digesting, maybe help the hostess clean the table, do the dishes by hand but get moving!

If you are hosting your family and friends and several have a type two diagnosis you could feel a little nervous about making items they can actually eat and enjoy. But we asked Ashley about this very scenario, and she had some great advice! "The most important thing with any diabetes is monitoring carbohydrate intake, and so when we have a lot of sides that are very stuffing, potato, or sugar heavy, those are added carbs that may raise people's blood sugars. So, again if we think about things that we like that are fall type flavors, roasted vegetables tend to go well with a Thanksgiving type of a meal."

Some other items include simplifying side dishes with a less is more approach by using seasonings like sage, thyme, or rosemary. For dessert instead of having a full apple pie maybe consider baking a fruit crisp or some apples in a little brown sugar and cinnamon as a treat for those diagnosed with diabetes gathered around your table. A note of caution as you are shopping though, sugar-free may not be a workable solution!

"Sugar-free foods aren't always carbohydrate free, and so being well-meaning, people with diabetes may still choose not to have that food item, because it still does contain carbohydrates," said Littleton. "Most desserts are that way. Most desserts can be sugar-free, but they are not carbohydrate free. And so even going more towards like a fruit crisp instead of necessarily a pie that has a little bit less sugar in it, may be a little bit less carbohydrate from flour from the crusting things, might be a nice dessert to have as an option."

One of the most important aspects of going into any holiday that revolves around food is to have a plan of action. Taking the tools, you have for your health and keeping to your plan so that you aren't derailed. Ultimately it's your health, even if you feel pressured by family or friends to take an extra bite here or there. Good decision making, a healthy approach to the traditions on our dinner tables and a great support system in your health care provider team can go a long way to success this holiday season.

If you have any questions about your diet, its impact on your diagnosis, or how you can make better choices when it comes to your nutritional intake be sure to contact Ashley Littleton at our Medical Office Building, 307-358-7300