Food and diabetes plans
Goals of the meal plans
Children with diabetes benefit from eating a healthy diet just like any other child. Although children with diabetes do not have to follow a special diet for this disease, they need to pay more attention to when they eat and how much food they include in their dishes.
The goals of the meal plans for children with diabetes are the same as for other children: They need food to help them have good overall health, normal growth and healthy weight.
But children with diabetes also have to balance their carbohydrate intake with the insulin they inject and their level of physical activity to keep their blood sugar levels under control. And they should eat foods that help them maintain the concentration of blood lipids (fats such as cholesterol and triglycerides) within healthy margins. By acting in this way, they can help prevent some long-term health problems of diabetes.
Food labels
You need to know what the food that serves your child contains. Therefore, look carefully at food labels to know the ingredients, nutritional information and calorie count of each food.
Look at the information on carbohydrates, which can affect the concentration of blood sugar. Generally, carbohydrates appear clearly in the food label listings and are expressed in grams. The two main forms of carbohydrates are sugars and starches (or starches). The types of sugars include the following:
fructose (the sugar present in fruit and some baked goods)
glucose (the main sugar in our bodies that is also found in foods such as cakes, cookies, pasta and soda)
lactose (the sugar present in milk and yogurt)
Starches (or starches) include foods of plant origin, such as potatoes (potatoes), corn and peas; cereals, such as rice, breakfast cereals and bread.
The body breaks down or converts most carbohydrates into glucose, which is absorbed by the bloodstream. When the blood sugar concentration increases, the pancreas releases a hormone called insulin. Insulin helps glucose enter cells so they can use it as a source of energy.
Regardless of the specific meal plan your doctor recommends for your child, it is important to be very aware of carbohydrates. This will help them balance the intake of carbohydrates, with the level of activity and insulin in order to achieve the best possible control of diabetes.
To calculate the amount of carbohydrates to be ingested, look at the size of the serving and the amount of carbohydrates per serving (both present on the food label) and determine how many servings your child can eat.
Here is an example:
serving size: ½ cup (120 milliliters)
carbohydrates per serving: 7 grams
amount of food ingested: 1 cup (240 milliliters)
grams of carbohydrates ingested: 14 grams (7 grams per serving x 2 servings)
What is the "adequate" amount?
There is not an adequate amount of carbohydrates that your child should eat. The recommended intake of carbohydrates is different in each child and may even differ in the same child from one day to another. Your child's diabetology team will make recommendations about carbohydrate intake as part of your meal plan.
Also look at the sodium (or salt) content that appears on food labels. Ingesting too much sodium is linked to high blood pressure (hypertension). Some children with diabetes have hypertension, and they may need to keep sodium intake within the range recommended by the doctor to reduce the risk of developing health problems related to excess sodium. It is always better not to go over sodium, even if your child does not have hypertension.
Also pay attention to the amount of fat and the type of fat. Saturated fats, cholesterol and trans fats can contribute to the development of heart disease. People with diabetes have a higher risk of developing heart disease, especially if they have an excessive concentration of lipids (fats) in their blood. Ask your child's doctor or dietitian if you should limit your fat intake.
How to plan the feeding
Try to maintain a good balance between carbohydrates and other nutrients at each meal, both for good diabetes control and for rewarding meals.
Here are some things to keep in mind:
Approximately 10% to 20% of the calories your child eats should come from protein. Try to choose lean meats, such as chicken or veal.
Approximately 25% to 30% of calories must come from fat. Avoid foods with many trans and saturated fats (or serve them only in moderation).
About 50% to 60% of the calories your child eats should come from carbohydrates. Encourage your child to eat many green and orange vegetables every day, such as carrots and broccoli. And choose brown rice and sweet potatoes, rich in vitamins, instead of white rice and potatoes.
Your child's diabetes treatment team will give you guidelines to plan the child's diet based on the foods he usually eats. The team may ask you and your child to keep a diary or detailed record of what your child eats over 3 days in a row to get an idea of what he likes to eat and in what quantities.
The team can recommend other things to plan your child's diet, depending on the child's individual nutritional needs. For example, if your child aims to lose weight, the doctor or dietitian will focus on monitoring calorie intake more closely.
The three main approaches in food plans
There are three types of meal plans that are used most often:
the food exchange plan
the constant carbohydrate feeding plan
the carbohydrate count meal plan
In the food exchange plan, food is divided into six groups: starches (or starches), fruits, dairy, fats, vegetables and meats. The plan establishes a ration of each of these food groups. Each serving has a similar amount of calories, protein, carbohydrates and fats. This allows great flexibility in meal planning, by exchanging or replacing different food options with similar nutritional content. The amount of exchanges (portions) of each group recommended for each meal and snack is based on the total amount of calories the person needs each day.
Your child's diabetes treatment team can provide you with food exchange lists. This type of meal plan is particularly useful for people with diabetes who are overweight or others who need to pay more attention to the amount of calories and nutrients they eat each day.
The other two approaches to food planning are based on following a balanced diet, but they focus specifically on adapting the amount of insulin or other diabetes medications to the amount of carbohydrates ingested. With a constant carbohydrate eating plan, the person ingests fixed amounts of carbohydrates at each meal and snack, then takes insulin or other diabetes medications at fixed times and fixed doses every day to control sugar rises in blood Although it lacks flexibility, this plan has the advantage of being simple and easy to follow for people whose food intake and whose level of physical activity are fairly constant from day to day.
Now, many people with diabetes use a carbohydrate counting plan where they calculate the amount of carbohydrates from the food they eat at each meal or snack. And then adjust the dose of insulin to that amount. This plan is most useful for people who control their diabetes by taking a dose of insulin (by injection or through an insulin pump) with each meal. This technique can help people achieve better control of blood sugar levels while controlling their diabetes. It also allows more flexibility, because the person takes insulin with meals, instead of at the same fixed times each day.
Useful tools
Keeping a written record of what your child eats can help you and your child's diabetes care team create and modify your eating plan when necessary. You can continue to record your child's carbohydrate intake along with their blood sugar readings to see if food intake and insulin are well balanced.
Children can check in when they are at school or away from home. If you need to make adjustments to the insulin dose, this written record can help you understand why and decide how much and at what time your child should inject the new dose.
It can also help to plan your child's meals by having a few references on hand, such as tables showing the size of the portions and the amount of carbohydrates that each food contains. The diabetes care team or your child's dietitian can give you all this information.
If you ever feel blocked when planning nutritious and well-balanced meals, inspiration is easy to find. Cookbooks and recipe pages on the Internet offer many proposals for healthy meals, many of which can be prepared easily and quickly. With your knowledge about diabetes and the right tools, you will be prepared to help your child eat well for good health.
