Our kitchen often receives special meal requests. One of the most challenging tasks is to create a meal plan for a person with a special diet mandated by a medical condition. It is difficult for those of us in the food industry, but especially challenging when you are not trained in the culinary field , and without the assistance of a professionally trained dietitian or physician.
In this article, we will discuss special meals for diabetics, those necessary for a medical condition a flight crew member or passenger may have. I truly believe that in order to understand the food required for a special meal you need some understanding of the ailment. Since I have been an insulin dependent diabetic in the past and have had to live on a diabetic diet, I am especially cognizant of this need.
What is Diabetes?
What is diabetes, how you get it, and why is diet so important to someone with this condition? There are two 2 types of diabetes, Type 1 and Type 2. Type 1 generally develops in childhood because the pancreas stops producing or doesn’t produce enough insulin for the body to prevent sugar build up in the blood stream. This type of diabetic takes insulin several times a day and must follow strict diets. Only 5 to 10% of those with diabetes are type 1. Type 2 diabetes tends to develop later in life, and is a combination of genes and lifestyle, and lack of activity (we all tend to slow down as we get older). Type 2 may be controlled through diet and exercise or with the addition of medication. Blood sugar levels are very important when dealing with the diabetic person; this is why menu planning is so important.
Some foods cause a rapid rise in blood sugar levels and others cause a slower reaction with the rise in blood sugar rising more evenly over time. I was once told that the high sugar levels in the body were like having thick syrup flowing through the arteries, and as the blood passed through, it clogged up and hurt every part of your body… like sugar in a gas tank??? Because, every human being’s blood sugar levels are affected by food, it is important for the diabetic to have his/her sugar level rise slowly and remain steady. That is why the diabetic passenger or crew should eat:
When you plan a diabetic meal, you need to know the individual’s current eating patterns. You will have to make inquiries to determine how many meals (and how large) need to be provided for that passenger or flight crew member. Diabetics also need to plan their meals, to eat about the same amount each day and at about the same time each day to help maintain normal blood sugar levels. It is also important when planning meals for the diabetic not to skip a meal or snack if that meal is “normal” for that passenger or flight crew member. If their sugar levels drop too low, they may fall into a diabetic coma. Or their sugar levels will rise too much and have the reverse reaction- hypoglycemia. In each instance, planning is key.
So how do you plan a meal for a diabetic?
You need carbohydrates high in fiber that will slowly release sugar into the body. In an effort to understand good and bad choices, let’s consider the following.
There is no standard diabetic diet that works for everyone. Not to worry! The diabetic diet needs to be heart healthy, calorie conscious, high in fiber , high in nutrients, and low in fats and sweets. To achieve this , the meals must be full of whole grains, vegetables, legumes, fruits and healthy plant -based fats and omega 3 fatty acids (here comes the olive oil, sunflower oils and those fish rich in Omega 3).
In 1994, the American Diabetes Association lifted its absolute ban of sugar for diabetes. This decision was based on scientific research that a carbohydrate sugar does not raise the blood sugar level more or faster than straight sugar so the focus switched to a carbohydrate counting based program. The American Diabetes Association gives the following simple tips for diabetics to follow when making smart food choices for each individual:
Carbohydrates are your body’s main energy source. Experts recommend that half your daily calories should come from carbohydrates. Tracking how many carbohydrates you eat—along with setting a maximum each day – will help you keep your blood sugar within the target range.”
Here’s a quick look at the 3 types of carbohydrates and the best food sources for them:
Following is a system, adapted from the American Diabetes Association, I have used in menu planning for myself. It can be used for the general population or for the diabetic on board.
Using a dinner plate, draw an imaginary line down the middle of your plate, then divide the left side of your plate once more into 2 equal sections. Now you have 3 sections on your plate – 2 small and 1 large.
For every meal, try to fill the largest section with non-starchy vegetables such as spinach, carrots, lettuce, greens, green beans, broccoli, cauliflower, tomatoes, or cucumbers, cabbage, bok choy, vegetable juice, salsa, onion, beets, okra, mushrooms, peppers, turnips. Be sure to eat a wide variety of foods. Having a colorful plate is the best way to ensure that you are eating plenty of fruits, vegetables, meats, and other forms of protein such as nuts, dairy products, and grains/cereals.
In 1 of the small sections, place starchy foods such as whole-grain breads(whole wheat or rye) whole grain or high fiber cereal, cooked cereal such as oatmeal, grits, hominy, cream of wheat, polenta, muesli, rice, pasta, tortillas, cooked beans or peas (such as pinto or black-eyed), potatoes, corn, lima beans, corn, sweet potato, winter squash, green peas low-fat crackers or chips, or pretzels.
In the other small section, put your low-fat meat such as a deck-of-cards-size piece of chicken, turkey without skin, tuna, salmon, cod, catfish, shrimp, clams, oysters, crab, mussels, lean beef, sirloin, or pork; or go with high-protein meat substitutes such as tofu, eggs, or low-fat cheese. In a diabetes diet, protein should account for about 15% to 20% of the total calories you eat each day.
Add 8 ounces of milk or 6 ounces of yogurt or a small piece of bread( which can be used for a sandwich).
A piece of fruit or ½ cup fruit salad, a low fat dessert can be added provided the carb count for the meal is low. You can develop many strategies for including desserts in a diabetes diet. Here are some examples:
Use artificial sweeteners in desserts.
Cut back on the amount of dessert. For example, instead of two scoops of ice cream, have one.
It is important to remember that sugar is just one type of carbohydrate. Ultimately, the total grams of carbohydrates – rather than what the source of the sugar – is what needs to be accounted for in the nutritional management of the person with diabetes.
Include the following artificial sweeteners in your aircraft condiment drawer or request them from your food source:
When organizing the meal service for your passenger or flight crew with diabetes, consider making the following choices to cut their fat, salt and carbohydrate intake:
While I was on insulin all those years, people would comment that now I could eat no sugar; everything had to be sugar free. No more desserts (and for me no more cookies). That’s not totally true. A diabetic can eat almost anything he or she wants as long they make wise choices. The scheduler, the flight attendant, and the food source need to consider the nutrient value, portions, and proper food preparation. Choosing food wisely can help the diabetic passenger or flight crew lower their risk of heart disease, stroke, and many other problems caused by diabetes. Menu planning for the diabetic will take some planning and organization.