Staying Healthy While Traveling with Prediabetes

cropped-20140803-210352-758327041.jpgIf you have prediabetes, hopefully you are familiar with strategies to lower your blood glucose and avoid the progression to diabetes down the road. Making the right food choices and exercising regularly to keep blood glucose levels within normal range are key strategies for staying healthy. These lifestyle choices should be practiced during your daily routine at home, but can also be easily incorporated into your plans while traveling. It can be tempting to savor new foods and indulge on sweet treats when you’re away. However, you should strive to keep up the healthy lifestyle choices you keep at home. If you have questions regarding your diet while traveling, meet with a registered dietitian nutritionist (RDN) prior to your departure to gain more knowledge on foods and physical activity that can keep your blood glucose within normal range. If you check your blood glucose at home and are still working on getting it into a healthy range, bring your glucometer with you so you can stay on track when you travel.

Here are some tips to help you stay healthy during your travels:

  • Avoid sugary drinks. Drinking sweetened beverages is a quick way for blood glucose levels to rise. Avoid sodas, juices, and sugary coffee beverages. Instead, enjoy water, seltzer, or unsweetened tea or coffee.
  • For breakfast, skip the sugary cereals and baked goods. Try some oatmeal or yogurt with fresh fruit, or egg whites on whole grain toast. Bring some packets of plain oatmeal with you and a bag of nuts or energy bars, such as KIND, so you have healthy choices readily available.
  • Make sure you eat balanced meals when going out for lunch or dinner. Fill half of your plate with fruit or vegetables, and include whole grains and lean protein, such as tofu, beans, grilled fish, veggie burgers, or chicken.
  • Eat every three to five hours to keep your blood glucose level steady. Have a meal or snack which includes a carbohydrate rich in fiber, such as fruit or whole grain crackers, paired with a healthy protein,  like nuts or hummus.
  • For dessert, try to order fresh fruit or some plain yogurt and fruit. If you order something very sweet, try to keep your portions smaller.
  • Keep up your exercise. A great and easy way to do this while traveling is to walk to some of your nearby destinations. Aim for 30 minutes of brisk walking per day.
  • Be smart about your snacks. Do not just grab the most convenient snacks; choose them wisely! Between meals, enjoy a fresh fruit, vegetables with hummus, rice cakes, or some mixed nuts. Stock up on some of these snacks before you leave home, so you always have a healthy snack on hand.
  • Do your research. If you are traveling abroad and want to try some of the traditional foods in your locale, do some research online to check ingredients or ask your waiter. If a dish is rich, order it as an appetizer or share with your dining partner. For the most part, try to stick with grilled fish, seafood, chicken or vegetarian proteins, such as tofu and beans. Enjoy salads and vegetables dishes. Have fun on your trip!

Helpful Travel Apps

For U.S. travel:

  1. Eat Well Eat Out-find healthy dining options in your locale complete with nutrition information. Developed with The American Diabetes Association.
  2. Food Tripping-healthy food establishments located wherever you are traveling
  3. FitTravel Guru-plan your trip and workouts with one app

Traveling abroad:

  1. EatWell EU-the Europe healthy food travel guide
  2. EatAway-fully customizable diet translator for most diet restrictions

Lisa Stollman, MA, RDN, CDE, CDN is the author of the ebook The Trim Traveler: How to Eat Healthy and Stay Fit While Traveling Abroad (Nirvana Press 2014) and The Teen Eating Manifesto (Nirvana Press 2012.). She is a nationally-recognized Registered Dietitian Nutritionist with a specialty in teen and adult weight management and diabetes. Lisa received her B.S. in Food and Nutrition and her M.A. in Clinical Nutrition from New York University. She consults with clients in Huntington, New York and on the Upper East Side of Manhattan. Special thanks to the fabulous writing contributions of nutrition intern, Anita Renwick. To find out more about Lisa or to book an appointment, please visit here.

Healthy Travel Tips For Before You Go Abroad

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Getting ready to travel abroad for even a few days can be truly exasperating. From making sure your passport is ready to-go, to making sure your hotel  (and for some, school courses) is confirmed and any required vaccinations are up-to-date. There are SO many loose ends to pull together, it can make your head spin. But don’t fret. Make a list of what you need to have done, so by the time you get comfortable in your plane seat, all of your to-dos will be checked off. Keeping a list and checking it off as you finish a task will help you reduce any stress. If you want to keep a list online in one convenient place, try the Finish app (available for free) in the Apple store. You can list your “to-dos,” set deadlines, and check them off as they get completed.

Order Your In-Flight Meal
If you aren’t usually fond of the typical airplane fare, or have special dietary requests, you can order a special meal usually up to 48 hours before you depart. Many airlines will let you order your special meal request online. There’s a vast variety of meal selections to choose from. If you have any allergy or intolerance such as celiac disease, you can be assured that you can find dairy-free or gluten-free  in addition to a host of other diet modifications.  To find the list of available meal selections, visit your airlines website and do a search for special meal requests.

Familiarize Yourself in the Local Food Culture
Familiarize yourself with the local cuisine where you will be traveling. Learn the  names of popular dishes and what is in them. Becoming familiar with the food will help you when dining in restaurants. You can check the Internet for the cultural foods at your destination country. Then you’ll be aware of the foods offered on local menus, whether you’re grabbing a meal at the hotel cafe or fancy restaurant. It’s also wise to plan ahead and check out the menus online of any restaurant you plan to visit. This way you’ll know if you should make a reservation or find another spot. Especially if you have food allergies or intolerances, you need to be informed in advance of the local cuisine and the potential allergens or ingredients it may contain.

Pack Some Food
Quite often when we are overwhelmed with just the thought of travel, we somehow forget about the food. You don’t want to get to the airport and take for granted that you will get a delicious meal served to you inflight and will find all the foods you love at home, when you get to your destination. So what should you do? Plan ahead! Staying well-fueled with good food will keep you feeling healthy and energized. Buy some healthy foods that are portable to bring along with you on the plane. Healthy granola bars, such as KIND or Kashi, are great for a snack or have two for breakfast! Bags of nuts and dried fruit are also good choices. Trader Joe’s sells large bags of individually-wrapped trail mix that’s great for traveling abroad. You can also pack a couple sandwiches for the flight. Peanut butter and banana on whole grain bread is a healthy sandwich to bring along. Also hummus, avocado and tomato on whole grain bread is delicious and quite portable.
Food To Bring
1 to 2 sandwiches for the plane
Fresh or dried fruit
Energy bars
Trail Mix
Individual bags of nuts

Bon Voyage!

Lisa Stollman, MA, RDN, CDE, CDN was recently honored as the The 2015 Outstanding Dietitian of The Year by The New York Academy of Nutrition and Dietetics. She is a speaker, blogger, entrepreneur and innovator who is passionate about spreading the message of healthy eating for optimal health. To help restaurants improve upon menu choices and food preparation, Lisa recently founded Eat Well Restaurant Nutrition where she collaborates with chefs. She is also the author of the e-book The Trim Traveler: How to Eat Healthy and Stay Fit While Traveling Abroad (Nirvana Press 2014) and the widely-acclaimed The Teen Eating Manifesto: The Ten Essential Steps to Losing Weight, Looking Great and Getting Healthy (Nirvana Press 2012). In her private practice, with offices in Huntington, NY and the Upper East Side of Manhattan, Lisa specializes in weight managment and diabetes for teens and adults. For more info, contact Lisa via email or visit here.

9 Tips For Traveling Abroad With Diabetes

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As any novice or expert traveler knows, planning the logistics of a trip, let alone the process of traveling, can get pretty tricky at times. This can be especially true for the adventurers with chronic medical conditions, namely those with diabetes. If you have diabetes and want to see the world but haven’t yet figured out how to balance the Colosseum with carb counting, or the Great Wall with glucose monitoring, then these tips are for you. Traveling with diabetes, whether Type 1 or 2, can certainly be a little stressful at times, but it is completely possible and should not hold you back from exploring the globe! Below is a list of 9 daily lifestyle tips for traveling with diabetes, made easy to implement in any adventure.

  1. Before you embark on your trip, if flying overseas, it’s good to know that you can order a special meal, usually up to 48 hours in advance. Visit the homepage of your airline and do a search for special menus. A review of Delta’s offerings shows that they serve 17 special menus. An overview of their diabetes menu states it’s low in sugar and avoids syrup and regular desserts. If you have high blood pressure or celiac disease, they also have a low sodium and gluten-free menu. But don’t fret. If you go with the regular menu, figure out your carb quota on the tray, so you don’t end up with a high blood glucose. Also, make sure to bring some healthy snacks, such as KIND bars, nuts, fresh fruit, and 100-calorie bags or popcorn. Keep some glucose tablets on hand in case of an emergency.
  1. Keep all medicines, syringes, inhaler and cartridges, blood sugar testing supplies, and all oral medications in your carry-on luggage. Don’t risk a checked bag getting lost or sitting in an unheated, uncooled cargo hold. If you usually carry a test kit and some exogenous source of insulin with you at all times, it may feel inconvenient to have to keep track of it during your travels. Luckily, medical equipment like test kits are available pocket-sized, and can be found at your local pharmacy. Store your insulin bottles and unopened packages of inhaled insulin between 33 F and 80 F. Don’t freeze insulin or keep it in direct sun. Once you open a package of inhaled insulin, you can keep it at room temperature safely for 10 days.
  1. Be aware of the potential language barrier in your destination country. In whatever area(s) you are traveling, certain words and phrases are critical to know and verbalize in the native language. It is too dangerous to assume that locals will be able to understand English in the event of a low blood sugar episode. Important phrases can include “I have diabetes,” “I have low blood sugar,” “I need medical assistance,” “I need a Coca-Cola” (most countries are familiar with, and carry, the iconic beverage). It is also crucial to carry an identification card or wear a medical ID bracelet that, in case of an emergency, explains your condition, which should have universal symbols that can be understood by any medical caregiver.
  1. In tandem with knowing the local language for speaking purposes, it is equally as important to be able to identify words that mean “bread,” and/or local dishes that are higher in carbohydrates. These can include pasta, potatoes, rice, pita, tortilla, or other local grains like quinoa or couscous. It’s also a good idea to practice reading nutrition labels in the local language; the word “carbohydrate” can be pretty easy to identify in some languages, but make sure you know what they are before leaving home. Also be wary that many European countries use Kilojoules instead of calories as a measurement of energy, and use commas instead of periods to designate decimals (for example, 12,5 grams as opposed to 12.5).
  1. If you are on insulin, you are probably pretty well versed on counting grams of carbohydrates. Despite your possible proficiency in carb counting, it may be helpful to refresh yourself on common exchanges of popular foods, like how 1/3 cup of rice or pasta is one exchange, and that one small slice of bread or dinner roll is one exchange. Also consider the sugar/carbohydrate content in syrups and dried fruit. It’s also a good idea to have a phone app such as HEALTHeDiabetes ($5.99 for iPhone) to check carbohydrate and sugar content of various foods. so you can quickly estimate the amount of carbohydrates in various dishes on the menu, before you order.
  1. You’ve probably heard that it is especially important to be mindful while sitting on a long plane, train, or bus ride. This is true or those with diabetes, as blood sugars tend to rise while remaining sedentary. Make sure to have your glucometer on hand at all times, and aim to test your blood glucose as needed to keep it in check. If you wear an insulin pump, you can temporarily set it to a higher basal rate during your travel, but make sure to go over those plans with your doctor or certified diabetes educator before heading out.
  1. The opposite is just as necessary to consider, as physical activity can deplete your blood sugar at an expedited rate. Make sure you have accessible forms of energy, like a granola bar or portable bottle of juice, to keep those blood sugar levels steady while you roam around Rio or traverse Tibet.
  1. In all cases, whether you’re driving a few states over or flying across the world,make sure you a card with your doctor’s name and phone number. Also keep a list of your current medications in your wallet and keep it with you at all times. And don’t forget a medical ID bracelet or card that states you have diabetes. Bring twice as many diabetic supplies as you think you need. Sometimes things just break, get stolen, or are lost in transport. Back-up supplies include an extra tube of glucose tablets for low blood sugar episodes, a back-uptest kit packed in another part of your baggage, extra insulin and/or oral diabetes medications, and extra medical condition cards in case your wallet is stolen.
  1. Last but certainly not least: eating! For many, traveling to new places is largely defined by new cuisines. Having diabetes has absolutely no hindrance on enjoying these new foods, as long as you stay mindful. If you want to sample a pizza in Florence for example, go for it (it’s practically necessary)! Keep the carb content in check by sharing the meal with a friend, or if you are alone, make sure you’re going to be exerting a lot of energy after your meal (like climbing up to the Piazzale Michelangelo). Limit the pizza to one or two slices and pair it with a salad. If you want to sample local desserts, opt for smaller sizes and try to balance it with a lower-carb meal, like a dish comprised of vegetables and a protein, like fish or a leaner meat source.

These may seem like a lot of things to keep in mind, when all you want to do is explore landmarks and experiment local cuisine like any other traveler. Visit here for more tips on traveling with diabetes. Following these tips can make your adventure run smoothly so you can get back to enjoying these amazing sights, sounds and tastes sooner. You are a traveler, and that means you are capable of dealing with anything that gets in your path on the road to new experiences. Happy travels!

Lisa Stollman, MA, RDN, CDE, CDN is based on Huntington, Long Island and New York City. She was recently honored as the 2015 Distinguished Dietitian of the Year Award by The New York State Academy of Nutrition and Dietetics. A special thanks to nutrition and writing intern Samantha Marks for her contributions to this blogpost. To find out more about Lisa, visit here.