QUESTION:  I work in a grocery store, and my schedule doesn’t permit me to eat at the same time every day.  I’m also finding it difficult to eat healthfully at work, and my diabetes control is suffering as a result.  I do have the ability to heat and eat frozen meals at work, however, and I’m wondering if you can recommend any such meals that would be good for my health?  Any suggestions would be appreciated.

ANSWER:  Spacing your meals and snacks evenly throughout the day will go a long way toward helping you maintain a healthy blood glucose level.  I recommend eating a meal or snack at least every four to six hours.  If your work breaks vary, I recommend a meal replacement drink or snack that you can consume easily and quickly.  Look for a snack that contains at least 7 grams of protein and approximately 15 grams of carbohydrate.  Combining protein with sources of high-quality carbohydrate, such as whole grains, legumes, and fiber, will help control your blood glucose levels.

Here are a few suggestions for quick and healthy snacks: A no-added-sugar peanut butter sandwich on whole-grain bread; 1/4 cup of nuts with one or two tablespoons of nuts with dried fruit; plain, nonfat, or 1% Greek yogurt (which is significantly higher in protein than regular yogurt).  Aim for yogurts that have fewer than 20 grams of total carbohydrate per serving by avoiding yogurt with added sugar.  You may want to add half a piece of fresh fruit or a handful of berries to a plain yogurt instead.

For a meal replacement drink or filling snack beverage, I recommend a high-protein, low-carbohydrate drink such as Boost Glucose Control, available in most supermarkets and pharmacies.  Each 8-ounce serving contains 16 grams of protein, 16 grams of carbohydrate, 3 grams of fiber, and 190 calories.

For frozen meals, the Nutrition Facts panel on the label is a good place to start.  I recommend meals with approximately 45-60 grams of carbohydrate (or 30-45 grams if you’re trying to lose weight), at least 15 grams of protein, and at least 3 grams of saturated fat.  A balanced meal will contain vegetables, lean protein, and some carbohydrate.

Some healthy frozen entrees include Healthy Choice’s Cafe Steamers (try Grilled Chicken and Pesto with Vegetables or Balsamic Garlic Chicken), Kashi’s Steamers Meals (Roasted Garlic Chicken Farfalle), or Amy’s Light in Sodium Vegetable Lasagna.  Keep a bag of non-starchy frozen vegetables handy to add to your meals.  Try to avoid frozen dinners with breaded foods, fried foods, cream sauces, and gravies.

Better yet (and less expensive), use leftovers from dinner to make your own frozen meals to keep in the freezer at work and heat up in the microwave.  Make at least half your plate vegetables, a quarter of it lean protein (approximately 3-4 ounces), and the rest (about a cup) starch.

You may find it helpful to speak to your supervisor and explain that you need to eat every few hours for health reasons-you don’t necessarily have to reveal that you have diabetes.  You can even get a note from your doctor that describes your requirements without giving the specifics of your medical condition.

If you continue to have trouble controlling your blood glucose level, I recommend you see your doctor to determine if you may need to add a medicine to your diabetes treatment plan or if a medicine you’re currently taking needs to be adjusted.  If you haven’t already, I also highly recommend that you see a registered dietitian.  A dietitian will work with you to figure out what eating plan best fits your lifestyle.  The Academy of Nutrition and Dietetics has a tool on their Web site,, to help you locate a dietitian in your area.

References:  Laura Bady, RD, CD, Registered Dietitian/Nutritionist, BellmedHealth, LLC, Bellevue, Washington   / Diabetes Self Management Magazine January/February 2013





Toddler obesity risk linked to family feeding practices by six months old

(daily Rx News) Childhood obesity continues to be a growing health issue in the US and across the world.  Children’s risk of becoming obese may start from their earliest days on earth.

A recent study looked at how feeding practices might affect a child’s risk of being obese at age 2.

The researchers found that breastfed babies were much less likely to be obese as toddlers than formula fed babies.

Babies were also more likely to be obese at age 2 years old if their parents introduced them to solid foods before 4 months old or if their parents put them to bed with a bottle.

“Ask your pediatrician about baby feeding practices.”

The study, led by Benjamin G. Gibbs. PhD, a professor in the Department of Sociology at Brigham Young University in Utah, aimed to understand how baby feeding practices might influence a child’s obesity risk.

The researchers used data from a long-term study with 8,030 children who were tracked from 9 months old to kindergarten.  The study group represents a typical group of American children born in 2001.

The researchers gathered data on whether the children were breastfed or formula fed, when they first began solid foods and whether they went to sleep with a bottle.  This information was based on interviews with the mothers when the babies were 9 months old.

Then the researchers looked at the children’s obesity rates at age 2.  Obesity at age 2 was determined as being in the 98th percentile for weight, which is 25 pounds or heavier for boys and 24 pounds or heavier for girls.

The researchers gathered demographic information about the families, including their socioeconomic status based on the family’s household income, the parents’ education levels and the parent’s occupations.

The researchers also gathered data on the mother’s weight and age when they gave birth.  Finally, they asked whether the mothers smoked, whether they had depression and whether they used daycare.

The researchers found that babies who were mostly fed formula for their first 6 months were two and a half times more likely to be obese when they were 2 years old compared to the babies who were exclusively breastfed until 6 months old.

Of the 1,225 babies (15 percent of the total) in the study who were predominantly breastfed until 6 months old, only 5.6 percent were obese at 2 years old.

Of the 2,495 babies who were predominantly formula fed until 6 months old (31 percent of the total group).  11.7 percent were obese at 2 years old.

Of the 4.310 babies who were breastfed and formula fed until 6 months old (54 percent of the total).  9.6 percent were obese at 2 years old.

Babies were also more likely to be obese at age 2 if their parents introduced them to solid foods before 4 months old and or if the child went to sleep with bottle.

Only 8.7 percent of the breastfed babies who went to bed with a bottle or received sold foods before 4 months old were obese at 2 years old.

However, among formula-fed babies, 39.9 percent of those put to bed with a bottle and 29.2 percent of those fed solids before 4 months old were obese at age 2.

The body mass index (BMI) of the child’s mother was not strongly liked to whether the child was obese at age 2 or not.  However, 30.7 percent of formula fed babies whose mothers smoked were obese at age 2, compared to 5.1 percent of breastfed whose mothers smoked.

Past research has already shown that babies from a lower socioeconomic status have a higher risk of becoming obese.  The researchers in this study determined that a large part of that link relates to the family’s baby feeding practices.

“The encouragement and support of breastfeeding and other healthy feeding practices are especially important for low socioeconomic children who are at increased risk of early childhood obesity,” the researchers wrote.

The study was published April 2 in the journal Pediatric Obesity. No external funding was noted in the study.  The authors declared no conflicts of interest.

References:  Pediatric Obesity, “Socioeconomic status, infant feeding practices and early childhood obesity”