Your ‘Ask the Dietitian’ questions answered: Thanksgiving Edition

Earlier this month, readers submitted their diet and nutrition questions related to the upcoming Thanksgiving holiday. Today Rosemary Mueller, MPH, RD, LDN, who is a registered dietitian and licensed nutritionist with Advocate Medical Group Weight Management is answering a few of those questions.

Sharon: As a recent “graduate” of the Advocate Weight Management program, I want to continue in my lifelong quest of healthy eating! Can you offer suggestions to lighten up the must-have stuffing and gravy everyone wants on Thanksgiving?

Rosemary: There are many different options to lighten up stuffing and gravy recipes. For a more traditional stuffing you could omit or greatly limit fat, such as butter, spread or oil, in stuffing and use low-salt broth or stock instead. In the stuffing, omit sausage, giblets or ground meat and substitute more vegetables. If you are wanting to try some new alternatives to traditional stuffing:

• Add fruits, such as apples, dried cherries or cranberries in place of sausage or meat
• Try farro, quinoa, or wild rice as the starch component
• Add mushrooms for an earthy flavor; nuts (in moderation) for protein and crunch
• Make your own stuffing bread crumbs from a variety of whole grain breads for an interesting change of pace and more fiber

Fat-free gravy can be quite tasty: use drippings from the roasting pan with all the fat skimmed off and add reduced salt chicken stock-as needed. Gravy does not have to be a “salt-fest.” Fresh herbs and ground black pepper can add flavor.

Cornstarch is very close to flour in terms of its calorie and carbohydrate content and slightly lower in vitamin/mineral content as compared to flour; however, pure cornstarch is gluten-free, and can be used to make gluten-free gravy, helpful for those with Celiac disease who must abstain from gluten.

Denise: I’m recently been diagnosed with Celiac disease. What do I need to avoid in the traditional Thanksgiving dinner?

Rosemary: If you are cooking the meal, you shouldn’t have to avoid anything as you are in control of the kitchen as long as you use only gluten-free recipes and ingredients. But it’s also possible to make just about everything on the traditional Thanksgiving table gluten-free. Not all foods need to be made completely from scratch as there are a number of convenient gluten-free packaged foods, including gluten-free stuffing, available at the grocery store.

If you are not the only one preparing food for the meal, you cannot assume that anything on the table is necessarily safe. Here are some tips that may help you avoid eating gluten:

• If you are doing the cooking and others insist on contributing, ask them to bring non-food items, such as extra ice, a bottle of wine, flowers or candles.
• If an inevitable gluten-filled dish arrives, graciously accept it, but serve it away from other foods to avoid cross-contamination.
• If you must attend dinner somewhere else, take along a few favorite gluten-free food dishes that will be safe for you to eat.
• Make sure you have separate serving utensils for your gluten-free items and explain to others that “spoon swapping” between dishes can be dangerous for you.
• Avoid the butter/spread dishes as this is frequently contaminated by butter knives used on bread or rolls containing gluten.
• When re-heating dishes, if gluten-filled and gluten-free dishes share the microwave or oven, be sure all dishes are covered with lids or aluminum foil.

If properly prepared and not cross-contaminated, the following are generally gluten-free: fresh, plain turkey prepared without adding broth, spices or other ingredients which is not stuffed; freshly-made cranberry sauce (check ingredients on store-bought cranberry sauce); mashed potatoes made with fresh potatoes, butter or oil and milk or gluten-free broth; cooked fresh vegetables, such as green beans or corn, with or without added fat, such as butter or oil; salad with gluten-free salad dressing.

To find more gluten-free recipes go to www.celiac.com.

Ashwani: Is it true that a single, large calorie meal can trigger a heart attack?

Rosemary: Although it sounds strange that an extremely high calorie meal could be that risky, for some people a large, very high fat meal could have a variety of immediate adverse effects. This is particularly true for those with established cardiovascular disease or risk factors for the disease. Here are some possible health conditions which can be triggered by a large, high fat meal:

• Reduced blood flow/stiffer arteries: Large, high fat meals can impair the ability of blood vessels to dilate or expand when necessary. For individuals with this issue, post-“big meal” exercise might cause angina or even trigger a heart attack.
• Increased heart rate: Digesting any kind of a large meal causes heart rate to increase because of the increased demands from the digestive tract.
• Increased blood pressure: The release of norepinephrine, a stress hormone that can raise blood pressure and heart rate, can be triggered by the presence of a large amount of food in the gut.
• High triglycerides: Although any meal will raise the amount of triglycerides in the blood, levels will be higher still when a fat-rich, refined carbohydrate meal is consumed, and levels can remain higher for 6-12 hours after eating. Pair this type of meal with alcohol, and triglycerides will rise even more.
• Blood sugar: For someone with diabetes, a large, fatty meal can impair the body’s ability to process glucose.
• Heartburn: Individuals with gastro-esophageal reflux disease (GERD) will experience worse symptoms after a large, fatty meal.

The bottom line: healthy and/or younger people without risk factors may not experience problems with an occasional over-indulgent meal. But if someone has high blood cholesterol, high blood pressure, diabetes, pre-existing heart disease, is very overweight, or is a smoker, “going overboard” can be a really bad idea. Better to savor smaller portions – yes, even on Thanksgiving.