Michel Nischan, renowned chef, best-selling author, and winner of the 2004 James Beard Foundation Cookbook Award, is credited with creating a cuisine of well-being. He focuses on pure ingredients and allows their natural flavors to dominate his dishes. Chef Nischan offered to share his personal relationship to type 1 diabetes and provides nutrition and cooking tips for people with type 1 diabetes.
JDRF: How did you react to learning that your son had type 1 diabetes?
Michel Nischan: It was different with each son. Chris, who is now 15, was diagnosed at age 5. Both Lori and I were stunned, saddened, and angry. First we thought, “Why Chris? Why should this beautiful young boy have to go through something like this?” Then we realized we had to mobilize as a family. We decided that whatever changes in diet had to be made, the whole family would make together. When Ethan was diagnosed two years ago at age 2, we thought, “Enough already!” Interestingly, our shock was very short lived and quickly replaced with the realization that it was better us than someone else because we were equipped to deal with it. We also view it as a reaffirmation of my quest toward cooking for well-being.
JDRF: Please describe a sample day-in-the-life of your family’s meals.
MN: For breakfast, Irish-cut oatmeal with dried berries and homemade applesauce for sweetness along with a scrambled or over-egg, grain toast and a glass of 1 percent milk.
Lunch: Meat sandwich on grain bread, carrots and celery or cherry tomatoes (depending on the season), 1 percent milk, and an apple with some peanut butter.
Dinner: Green salad with extra veggies like blanched green beans, peas, etc., roasted chicken with skillet-browned broccoli, mashed purple or Yukon potatoes, or fried rice using brown rice.
Snacks: Things like apple wedges with peanut butter sprinkled with good quality granola seems to be a favorite. Anything with a protein/mono-unsaturated fat combo helps the snack serve its purpose of holding a kid over until mealtime.
Dessert: We’ll have ice cream if the salad and entrée were particularly healthful. If we make fried chicken, we’ll do fresh fruit or do a small dessert for a bed-time snack along with a half peanut butter sandwich. For those who are having difficulty with advanced meal planning, try Splenda®. You can replace it cup-for-cup in most baked recipes that require sugar. If your kids are used to cupcakes and brownies, this product helps take the pressure off. I believe you should try to help your children turn away from super-sweet desserts, but for many, this is a monumental task, especially if your child or children were diagnosed at a later age. Still, the overall goal should be to wean yourself and children from liking overly sweet things.
JDRF: Can those with type 1 diabetes still eat their favorite foods and snacks?
MN: I like to point out that not all favorites are unhealthful, but most are. When asked by my sons for questionable favorites I say yes, but proceed with caution. The overall behavioral problem with our society is that we tend to eat our favorite foods all the time. It is this tendency (coupled with the fact that most “favorite” foods are fast foods, junk foods, or desserts) that leads to so many of our current health problems.
Moderation is the key. No one should ever think it’s fine to ramp up on insulin and all will be well. The best approach is to work your favorites into your meal plan so they become a regular, but not constant, part of your weekly diet. This allows you to encounter your favorites regularly and to feel less deprived. Most people have at least half a dozen favorites, so I advise them to spread the favorites evenly throughout their meal plan, and to avoid having more than one favorite per meal period. For example, if you’re going to binge on a favorite fried food, don’t follow it with a couple of Twinkies or a bowl of double fudge ice cream. If you’re going to have strawberry short cake, have it at the end of an otherwise healthy meal. Last tip: Don’t do favorites as straight snacks. Consuming your favorites simultaneously with good proteins, veggies, and good carbs helps buffer the impact of the oh-so-good junk.
JDRF: What are some recommendations about eating during Halloween, Thanksgiving, and Christmas?
MN: For Chris’s first Halloween, we looked at our Christmas budget and put some money aside to exchange his Halloween candy for toys. We upped his insulin and allowed him some candy on the holiday. The next day, he got to “cash his candy in” for toys. We allowed him a little candy that day to make it easier to let go. He consumed at least 90 percent less candy and had no problem with it.
Thanksgiving is easier because candy is not involved. My kids never like store-bought cranberry sauce, but they love the homemade kind. I make it with freshly pressed apple juice and cider and lots of orange zest. While it’s still up there on the glycemic index, it’s gentler than the stuff filled with sugar and corn syrup. We also do more fresh fruits with desserts and have eliminated white sugar and flour from most of our baking.
Christmas is also easier because again, unlike Halloween, candy is not the over-riding theme of the holiday. Stockings get stuffed with small toys, knick-knacks, CDs, and fresh fruits. Because we eliminated most candy early in Chris’s life with type 1 diabetes, he doesn’t like peppermint candy, which of course, makes candy canes a non-issue. We enjoy cooking roast turkey and roasted fresh ham. Fresh ham is the same leg cut as a sugar-cured or smoked ham, but is un-treated so it does not beg for a honey or brown sugar glaze. Lots of broccoli and other seasonal veggies adorn the table and the kids dig it. They’re usually too full for dessert so we downplay dessert and make beautiful displays with sliced fresh pears, melons, and other stuff.
JDRF: How do you and your family handle type 1 diabetes on a day-to-day basis?
MN: Our day-to-day approach has changed with Chris’s own physical and emotional changes. This is perhaps the greatest challenge to all parents. First there is the fast growth rate and ever-changing metabolism, then there’s adolescence and the naturally occurring rebellion that accompanies adolescence. Chris was on the pump and was doing great until his social life ramped up with adolescence. Because of increased social activity, he would often neglect to check himself and administer his insulin. He’s also, at times, experienced a resentment of his type 1 diabetes–a resentment we sometimes share. As a result, Chris agreed to come off the pump in order to ensure Lori’s and my participation in the administration of his insulin. While it’s been a humbling hassle for all of us, his numbers have improved dramatically and he now misses the pump and feels ready to go back to it.
I believe it’s psychologically and socially important for parents to acknowledge these types of difficulties and understand they are not failures. So many parents avoid openly discussing these types of problems because so many other families with type 1 diabetes are purported to be in “perfect control.” Ongoing denial is a symptom that can be almost as dangerous as the disease itself.
As far as diet is concerned, we worked very hard to change the diet pattern of our whole family, however, the teenagers are more mobile and spend more time away from home. Fast food and junk food are more desirable for their “hangin-out” and “on-the-go” lifestyles and we don’t want to be the food police. The natural rebellious nature of teens is only exacerbated by over-control. With Chris, we worked specifically on counting carbs and keeping the carb-counter book close to him so he could administer his insulin accordingly. My prayer is that my influence regarding more healthful foods will eventually win out with Chris as my mother’s influence did with me.
Ethan recently went on the pump so we’re looking forward to seeing how that will work for him. He’s excited about less shots and got some cool new toys for being a very brave boy.