For some parents, planning and cooking a traditional Thanksgiving meal can be stressful enough, but ensuring that the meal is balanced with healthy food options and appropriate portion sizes for children with diabetes can add extra stress. Children with diabetes have enough trouble managing their sugar intake, and with Thanksgiving favorites like stuffing and mashed potatoes, the hidden sugars in carbohydrates are easy to overlook. Children’s National Health System’s Endocrinology dietitian Erika Davies has tips for Thanksgiving meals for diabetic children to help ease some of the pressure.

So, what does a balanced Thanksgiving meal include? According to Davies, a balanced Thanksgiving meal for children with diabetes should consist of: turkey or mashed potatoes or stuffing (not all three unless they have very small portions), a salad, a non-starchy vegetable and a glass of fat-free milk.

“A very small piece of dessert is also acceptable but limits should be placed on the amount. Fruit with some sugar free whipped topping can be a good dessert substitute. Cranberry sauce should be avoided because of the high sugar content,” Davies says.

Learning appropriate portions

Thanksgiving can be a great teaching opportunity for children to learn to enjoy eating a small portion from all of the food groups. Appropriate portion sizes for children with diabetes over the age of six are:

  • 3-4 oz. of turkey
  • ½-1 cup of starch (potatoes or stuffing)
  • ¼ cup gravy
  • ½-1 cup non-starchy vegetables (tomatoes, carrots, celery, broccoli, cauliflower, peppers)
  • 8 oz. of milk or a low fat yogurt
  • 1 serving of fruit

If children are still hungry, parents should provide non-starchy vegetables as seconds. Davies also notes that parents can try healthier alternatives to the traditional Thanksgiving recipes, including:

  • Mixing mashed cauliflower into the mashed potatoes to decrease the carb content.
  • Serving roasted sweet potatoes instead of preparing the dish with marshmallows or sugared nuts.
  • Trying fruit for dessert instead of pieces of sugary pies or cakes.

Monitor blood sugar

With some families gobbling down their Thanksgiving meal at odd hours of the day, Davies recommends testing kids’ blood sugar more often if the meal time does not coincide with their regular meal time. Davies explains that the effect of the irregular eating schedules on children with diabetes depends on the kind of insulin regimen the child has.

“Some children with diabetes will do fine as long as there is not a lot of snacking and waiting for meals,” Davies says. “Other children have a more rigid medication schedule so doing some adjusting in eating time may not be as easy for those patients.

Davies notes that it’s okay for children to have some treats on Thanksgiving, if they are doing well overall and the Thanksgiving festivities don’t last for multiple days. “Don’t get too upset if the blood sugars on Thanksgiving are not within range,” Davies says.

Get moving

In addition to monitoring children’s food choices and portion sizes on Thanksgiving, Davies recommends that parents make sure children play a lot instead of sitting in front of the television watching Thanksgiving parades or football games.

“Physical activity is a big key to good blood sugars on Thanksgiving,” Davies said.

Sports medicine pediatrician, Nailah Coleman, MD, suggests family-friendly activities such as a walk around the block, playing interactive video games, playing tag in the front yard or a family bike ride.

What steps will you take this year to serve a balanced Thanksgiving meal for children with diabetes? Share your healthy holiday tips with us in the comments below!


Erika Davies, MD, RD, LD, is an endocrinology dietitian at Children's National.

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