Diabetes

Home » Diabetes » Nutrition for Children

Nutrition for Children with Diabetes

In children who have diabetes, keeping blood glucose levels on target is the main goal for controlling diabetes and maintaining health. To help achieve this, provide healthy food choices, offer regular opportunities for exercise, and follow the advice of a qualified health care provider for giving medication if necessary.

There are two different types of diabetes. However, the recommendations for healthy eating are generally the same for both types. Without proper attention, diabetes can damage the eyes, kidneys, nerves, and blood vessels. Because diabetes can increase a child's risk for developing high cholesterol, high blood pressure, and heart disease, detecting the condition early and getting it under control is very important. For infants and toddlers, keeping glucose levels stable and on target is crucial for healthy brain development.

One of the first things to do after a child has been diagnosed with diabetes or pre-diabetes is to talk with a qualified health care provider and a nurse educator or registered dietician about establishing a diabetes care plan. This plan may include a schedule for what, when, and how much the child should eat and when to give diabetes medication if necessary.

Accommodating the child's new dietary needs may require changes in the family's daily lifestyle. Ask a qualified health care provider, nurse educator, or nutritionist for advice about how to talk with the child (and family) about making the needed lifestyle changes to control diabetes.

Children who have diabetes basically need the same foods that all children need to grow and thrive. The following guidelines will help provide a healthy diet to help control the child's diabetes:

• Offer balanced meals at regular intervals every day.
• Learn how different foods affect the child's blood glucose level.
• Offer healthy snacks between meals.
• Encourage the child to drink water when thirsty.
• Choose whole-grain foods with higher fiber contents.
• Limit sweets, regular soft drinks, pastries, candy, jam, and honey.
• Limit saturated fat and cholesterol.
• Avoid trans fat (found in foods with hydrogenated or partially-hydrogenated oils).
• Build time into the child's daily routine for physical activity.
• Monitor blood glucose levels as directed by the child's health care provider.
• Learn how to treat high blood glucose (hyperglycemia) and low blood glucose (hypoglycemia).

When a child has diabetes, the body has difficulty managing the level of glucose (a type of sugar) in the bloodstream. Too little glucose in the bloodstream can cause tiredness and irritability. Too much glucose in the blood stream can damage the eyes and other organs. The amount of glucose in the bloodstream is referred to as the blood sugar or blood glucose level. When choosing foods for a child who has diabetes, it is important to know how different foods affect blood glucose levels.

Eating Balanced Meals

Children who have diabetes basically need the same foods that all children need to grow and stay healthy. Healthy eating for children with diabetes means eating plenty of fresh fruits, vegetables, and whole grains. It also includes choosing protein sources such as lean meats, poultry, fish, legumes, soy-based meat substitutes, and low- or non-fat dairy products.

• Include plenty of vegetables of various colors. (Good choices include spinach, broccoli, cauliflower, carrots, peppers, onions, eggplant, and kale.)
• Use whole grains such as 100% whole-wheat bread, brown rice, and whole-wheat pasta.
• Substitute beans or lentils for meat a few times per week.
• Eat fish 2-3 times per week.
• Choose lean meats and remove skin from poultry.
• Switch to low- or non-fat dairy products such as skim (or non-fat) milk, low- or non-fat yogurt, and low-fat cheeses.
• Use vegetable-based oils such as canola, olive, or corn oil when cooking.

Limit the child's intake of white or albacore tuna to no more than 6 ounces per week. Avoid shark, swordfish, king mackerel, and tilefish due to potentially high levels of mercury. Talk with a health care provider or registered dietician about the safety of fish in the child's diet.

For more information about a healthy diet, also see Healthy Eating, Protein, Carbohydrates, Fat, and Dietary Fiber.

Foods and Blood Glucose Levels

All foods are made up of the same three components: carbohydrates, protein, and fat. Of these components, carbohydrates have the most influence on blood glucose levels. Fruits, vegetables, and grains (e.g., cereal, bread, crackers, pasta, rice) are different types of carbohydrates.

When carbohydrates are digested, they are converted to glucose (a type of sugar) and are used immediately or stored for later use. Some carbohydrates are converted to glucose rapidly and some more slowly. How fast a carbohydrate is converted to glucose is important to patients who have diabetes.

When it comes to carbohydrates, fresh fruits, vegetables, and whole grains are healthier. When choosing food for a child who has diabetes, choose these carbohydrates more often:

• 100% whole-wheat bread
• Brown rice
• Whole-wheat pasta
• Fresh fruits and vegetables
• Oatmeal

Limit these carbohydrates:

• Breads made with refined flour
• Traditional pasta
• White rice
• Snacks with added sugars or sweeteners (including juices)

A dietician or nurse educator can provide more information about managing carbohydrates in the child's diet and how to keep blood glucose levels in balance. They can also provide helpful information about planning for holidays and special occasions, such as birthday parties and Halloween.

Choosing Healthy Snacks

A healthy snack is high in vitamins, minerals, and fiber, and low in fat and added sugar or sweeteners. A dietician can provide more ideas for healthy snacks, including the following:

• Fresh fruit with low-fat cheddar cheese
• Raw vegetables with low- or non-fat dressing or yogurt dip
• Whole-grain crackers with low-fat cheddar cheese

Whole Grains and Other High Fiber Foods

Foods made with whole grains are healthier choices than those made with refined flour. For example, 100% whole-wheat bread, brown rice, and oatmeal are better choices than white bread, white rice, and sugary, low-fiber breakfast cereals. Foods made with refined grains (such as white flour and white rice) can make blood sugar rise faster than whole-grain foods.

Tips for adding more fiber:

• Offer plenty of fresh fruits and vegetables.
• Switch to brown rice at home and request brown rice in restaurants.
• Buy 100% whole-grain bread.
• Substitute whole-grain pasta for traditional pasta.
• Choose breakfast cereals made with whole grains (containing at least 2.5 grams of fiber per serving).
• Check for whole grains in the ingredients lists of all grain-based products.
• Provide raw vegetables as snacks instead of chips, crackers, or candy.
• Substitute lentils or beans for meat 2-3 times per week.
• Provide a green salad with dinner or lunch.
• Try Indian, Latin, or Middle Eastern foods that have beans, lentils, or chickpeas.

Limit Saturated Fat and Cholesterol

Being overweight makes it harder for children's bodies to manage blood glucose levels and increases the risk for heart disease. Limiting saturated fat and cholesterol in the child's diet can help them maintain a healthy weight and better control diabetes.

• Limit meat and poultry serving sizes. Ask a dietician for appropriate serving sizes based on the child's age and weight.
• Choose leaner cuts of beef (e.g., cuts with "loin" in the name, 90% lean ground beef).
• Remove the skin from poultry before serving.
• Serve fish such as salmon, trout, and herring 1-2 times per week.
• Limit or avoid shellfish.
• Substitute beans, lentils, or tofu for meat 2-3 times per week.
• Offer low-fat or non-fat milk instead of whole or 2% milk.
• Substitute plain low- or non-fat yogurt for sour cream.
• Limit butter and avoid stick margarines completely. (Or use a special margarine that is made with plant stanols and sterols and is trans fat-free.)

Avoid Trans Fats

Trans fats, from hydrogenated and partially-hydrogenated oils, are unhealthy because they raise LDL ("bad") cholesterol and lower HDL ("good") cholesterol. Eliminating these from the child's diet can also help them maintain a healthy weight and avoid heart disease.

Check the ingredients lists on all foods and avoid foods that contain hydrogenated or partially-hydrogenated oils. Instead, choose products made with healthier unsaturated fats such as canola, olive, soybean, safflower, and corn oils.

To eliminate trans fats (hydrogenated and partially-hydrogenated oils) from the child's diet avoid the following:

• Stick margarine
• Some peanut butters (check the ingredients list)
• Most microwave popcorn
• Many pastries and other bakery items (also may raise blood glucose levels)
• Many crackers, cookies, and chips (also may raise blood glucose levels)
• Fast food French fries, fried chicken, and breaded chicken and fish patties

Daily Physical Activity

Talk with a qualified health care provider about what level of activity is best for the child. Start by encouraging 5-10 minutes of exercise each day. Aerobic exercise, that gets the heart beating faster and uses the large muscles, can help keep blood glucose levels in balance. It can also help lower cholesterol and blood pressure. Exercise also can help the child sleep better, feel more relaxed, and even help concentrate better.

Simple ways to work more activity into the child's life include the following:

• Walking the dog with a parent or friend
• Playing tag or going for a walk together
• Bike riding with a parent or a friend (wear a helmet)
• Raking leaves together
• Taking a hike as a family
• Taking the stairs instead of an elevator at the mall
• Roller skating, jumping rope, or swimming
• Joining a community sports program (e.g., soccer, softball, basketball)

Ask a qualified health care provider if the child should have blood glucose levels checked before starting an exercise program and about how medication may affect levels during exercise. Make sure the child has a snack available in case blood glucose levels get low.

Monitoring Blood Glucose Levels

Monitoring the child's blood glucose level and keeping accurate records can help the health care provider and dietician create the best possible diabetes care plan. As the child grows, becomes more or less active, and loses or gains weight the care plan should be reviewed and adjusted. If the child is having difficulty following the meal plan or blood glucose levels are not being properly controlled, contact the child's health care provider or dietician.

Parents of school-aged children who have diabetes should communicate regularly with the child's teacher and the school nurse. Talk with a dietician or nurse educator for more advice on how to enlist the help of the other caregivers in the child's life.

Maintaining Blood Glucose Levels

When blood glucose levels are too high over long periods, it can cause damage to the heart, blood vessels, eyes, and kidneys. When blood glucose is too low, the child may feel tired and unable to concentrate. If blood glucose becomes severely low, diabetic coma can occur.

Illness, skipping meals, eating too much or too little, exercising too much or too little, and emotional stress can cause the child's blood sugar to become too high or too low. It is important to learn how to detect the signs of low blood glucose and high blood glucose in the child and to know what to do in each case.

Talk with a qualified health care provider, dietician, or nurse educator about how to handle each of these situations. Also, make sure that other caregivers (e.g., school staff, coaches, babysitters) know how to spot the signs of high and low blood glucose.

Younger children require more help to monitor symptoms of high and low blood glucose. Ask a health care provider or registered dietician for suggestions to help children learn to better manage diabetes care as they mature.

Too little glucose in the bloodstream is called low blood sugar, low blood glucose, or hypoglycemia. Mild to moderate hypoglycemia is fairly common in children with diabetes. Signs of low blood glucose include the following:

• Confusion
• Grouchiness, irritability
• Tiredness

If the child has signs of low blood sugar, check blood glucose levels. If the level is under 70 mg/dL, try one of the following:

• Have the child drink ½ cup of grape or orange juice, 1 cup of milk, a juice box, or ½ can of a regular (not diet) soft drink.
• Give the child 2 glucose tablets.
• Give the child 1-2 tablespoons of sugar or honey.
• Have the child eat 2-4 pieces of hard candy, 5 gumdrops, or two tablespoons of cake icing.

Check the child's glucose again after about 15 minutes. If the level is still below 70 mg/dL, repeat one of the suggestions above until the level is above 70 mg/dL. If the child develops severe hypoglycemia, the child may become unconscious and slip into a diabetic coma. Talk with a qualified health care provider about dealing with this situation.

Children can also experience nighttime hypoglycemia. Signs of nighttime hypoglycemia (low blood glucose) include the following:

• Pajamas and sheets feel damp in the morning
• Headache in the morning
• Restless sleep
• Excessive tiredness upon waking
• High blood glucose reading (the body can react to the hypoglycemia by raising blood glucose levels)

Talk to a qualified health care provider about the best way to deal with nighttime hypoglycemia.

Too much glucose in the bloodstream is called high blood sugar, high blood glucose, or hyperglycemia. Signs of high blood sugar include the following:

• Excessive thirst
• Blurred vision
• Fatigue
• Frequent urination

Hyperglycemia can occur if the child is ill or not following the care plan closely enough. A brief period of exercise may help; however, exercise can be dangerous if the blood sugar level is too high. Ask a qualified health care provider in advance about what to do if the child experiences high blood sugar.

To help prevent the child's blood glucose from going out of balance, check the blood glucose levels as directed by a health care provider and follow the diabetes care plan as closely as possible.

Diabetes, Nutrition for Children reprinted with permission from podiatrychannel.com
© 1998-2008 Healthcommunities.com, Inc. All Rights Reserved.

Diabetes Resources

	Join Our Diabetes Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.	Advertising Disclaimer
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted.
	Stay Updated Sign up for our newsletter and receive important updates on the medical conditions that are most important to you.
To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar. Advertising Disclaimer