How to Manage Blood Sugar Levels During Rosh Hashanah

During Rosh Hashanah, it is customary to eat sweet foods and foods symbolizing wishes for the new year: apple dipped in honey, honey cake, pomegranate, date, fish head, and more. Therefore, people with diabetes, whether they inject insulin or not, must adhere to a proper diet and monitor carbohydrate intake to maintain balanced sugar levels. This requires planning and preparation for insulin usage during the holiday period, facilitated by understanding the carbohydrate content of the food.

Honey

Honey is a natural sweet substance attributed with many healing properties in folk medicine. Despite its reputation, it's important to note that honey is rich in sugars, similar to regular white or brown sugar. For some, honey causes a moderate rise in sugar levels compared to white sugar, but it is still considered a simple carbohydrate, less recommended for diabetics. Consumption should be moderate; consider when, with what (e.g., additional food components like protein or fat to moderate blood sugar rise), and how much honey to consume. Regardless, the aim should be minimal honey consumption, since significant amounts can raise blood triglyceride levels and increase liver fat.

Pomegranate

The fruit contains a substantial amount of antioxidants, helping to minimize oxidative damage caused by bodily processes, inhaled air, and sun radiation. Eating pomegranates is healthy but should be done in moderation, as the fruit also has high sugar content. About 100 grams of pomegranate seeds (half a small pomegranate) contain approximately 19 grams of carbohydrates. It's recommended to combine pomegranate consumption with a handful of almonds or nuts to reduce its glycemic index for a slower and lesser sugar rise.

Fish

Fish contain omega-3 fatty acids in varying amounts, offering numerous health benefits. They are part of the Mediterranean diet, proven to reduce the risk of cardiovascular diseases. Additionally, fish are low in saturated fats and cholesterol and rich in high-quality protein. It's generally recommended to eat fish at least two to three times a week, favoring northern sea fish rich in omega-3s such as salmon, sardines, and mackerel.

Black-eyed Peas

Black-eyed peas, part of the legume family, are rich in protein, dietary fiber, and complex carbohydrates that tend to absorb slowly in the blood for some people, causing a moderate rise in sugar levels. In 100 grams of black-eyed peas, there are 100 calories and 21 grams of carbohydrates, of which 7 grams are dietary fiber (therefore, the actual carbohydrates breaking down into sugar are smaller). Due to their carbohydrate richness, black-eyed peas are recommended as a carbohydrate serving in meals, providing variety with other carbohydrates like rice, potatoes, or pasta.

Beet

Beet is rich in vitamins and minerals, such as vitamin B, vitamin A, vitamin C, iron, magnesium, folic acid, calcium, phosphorus, potassium, and also has a high level of antioxidants. Due to its rich nutritional values, beetroot can help in heart protection, preventing high blood pressure, and more. Beet consumption, including drinking its juice, can aid those suffering from constipation. It's notable that even though beetroot is sweet, it can still be included in a diabetic's meal in a limited amount. 100 grams of beetroot contain 44 calories and 8 grams of carbohydrates.

Pumpkin

Pumpkin is low in calories and carbohydrates despite its sweet taste. Its orange color is an important antioxidant, aiding the immune system, protecting body cells, and slowing the aging process. Pumpkin is also rich in vitamins, minerals, and dietary fibers. 100 grams of pumpkin contain 37 calories and 6 grams of carbohydrates. Due to its relatively low carbohydrate content, it is recommended to include pumpkin in meals as an addition instead of sweet potatoes or potatoes.

Date

Dates are rich in carbohydrates, and for a significant number of people, they have a high glycemic index, meaning they digest and absorb into the blood quickly, rapidly raising sugar levels. To maintain balanced sugar levels, it is not recommended to consume dates in large quantities. A serving of dates consists of two dates (20 grams), equating to 60 calories and 15 grams of carbohydrates. Each date contains, on average, 1.5 teaspoons of sugar, and two dates are equal to 3 teaspoons of sugar (!).

Alcoholic Beverages

Intake should be limited, and it's important not to drink on an "empty stomach" but rather with a comprehensive meal including various food components. Alcohol affects sugar levels hours after drinking, demanding monitoring before sleep and post-meal. If including wine, it's recommended to choose red or dry white wine, not including it in the carbohydrate count. High alcohol intake can lead to an increase in blood fats (triglycerides) and is not advised in cases of fatty liver or other liver diseases.

In Conclusion

1. It's important to limit carbohydrate intake in meals, as they mainly influence sugar levels. Examples of carbohydrates include rice, potatoes, pasta, bulgur, noodles, or matzo balls in soup, challah, etc. Larger quantities of vegetables, proteins, and healthy fats like tahini, avocado, almonds, and nuts can be consumed.
2. It is recommended to check sugar levels approximately two hours after eating and cautiously correct them (keeping at least two hours from the previous injection).
3. During the holiday, it is advisable to eat in an orderly fashion and not skip meals to "save room" for the main meal, as this can lead to uncontrolled eating.
4. Use the holiday period for family hikes in nature and pre-plan time for daily physical activity. Holidays provide more time for sports; utilize it.
5. The best way to understand the effect of different foods on sugar levels is by using a continuous glucose monitor for personalized dietary adjustments, which helps understand sugar level fluctuations better and predict increases or decreases.

Einat Mazor Bakar is a clinical dietician at DMC Center for Diabetes and Obesity Treatment