With Thanksgiving right around the corner, it’s important to acknowledge this food-centric holiday can be tricky to navigate for our dialysis patients, especially if they have comorbid conditions like diabetes. Whether they will be hosting or attending a get-together, it can be difficult to stay focused
on controlling diet and exercise routines. As providers, we can help by focusing on a positive message, “you can still eat the foods you love while being mindful of how you are balancing your plate.”

Follow the plate method
Filling half of their plate with non-starchy vegetables such as green beans and brussels sprouts can help keep the feeling full for longer and provide essential vitamins and nutrients.

Dividing the last half into 2 quarters, fill one quarter with protein rich foods such as roasted turkey and the last half with carbohydrate foods like sweet potato casserole or mashed potatoes.

Once the plate is made, they should avoid adding extra salt and instead season with fresh and/or dried herbs or a squeeze of lemon depending on the dish.


Keep portions in check
Favorite foods such as pumpkin pie or mashed potatoes can remain on the menu, encourage them to opt for smaller servings of these foods.
Serving themselves on a smaller plate may help smaller portions appear more visually satisfying than if they were served on a large plate.

Bring a ‘go-to’ dish to eat and share
Help patients identify an easy to prepare dish that fits renal and diabetic diet guidelines that they will be excited to eat. They can bring it to the gathering
and have confidence that there is something available that suits their needs.


Be mindful of beverages
It can be easy to lose track of liquid and liquid calories at major events like Thanksgiving. Sticking with low sugar beverage options such as water, unsweetened tea, and seltzers should be encouraged.

Patients should also be reminded of the effect of salt intake on thirst. Keeping salt to a minimum, monitoring thirst, and staying on top of fluid restrictions
is important.

For more tips on managing thirst, visit the Clinician Portal for patient handouts and review our previous blog post, Beat the Heat this Summer.


Stay active
Taking a walk before and after the big meal will help with digestion and stabilize blood sugars.

Supporting good digestion can help alleviate constipation. Constipation has been proposed as a possible cause of high serum potassium
and phosphate levels.
Set reminders to take medications and check blood sugar levels
A lot goes on during the holidays, as patients break from routine it gets more difficult to remember even the most important of tasks.
It’s okay to acknowledge that slip ups are normal and expected, but there are steps patients can take to keep the important things top of mind.

  • Make sure they have packed all the necessary medications and equipment prior to heading out for any holiday events.
  • Set phone alarms and reminders to take medications as prescribed and check blood sugar levels as needed throughout the day.
  • Encourage them to set up an accountability buddy for the day, someone they give permission to provide gentle prompts or reminders
    to take their medications, etc.

Plan to get back on track
Even with preparation, there’s a good chance patients may overdo it, but we do not want them to stress about it and carry these behaviors forward. Instead, having a plan in place to get back on track once Thanksgiving has passed can help avoid compounding any potential problems that arise.

Thanksgiving is a wonderful time to enjoy the day with loved ones, even for our patients with a complex medical picture. As healthcare providers,
we can help patients keep the joy and fun in their holidays without sacrificing their health. If you are looking for some diabetic and renal friendly recipes you can find our Holiday Recipe book as well on the clinician portal.

Reference: Tips for Eating Well. (October 2, 2024). American Diabetes Association. https://diabetes.org/food-nutrition/eating-healthy

We thank our guest blogger Shelley Ragan, MS, RDN, LD, for sharing her knowledge and writing this blog post!