Diabetes: Healthy eating
Diabetes: Healthy eating
Healthy meal planning is an important part of diabetes management. There is no need for a child or young person to eat special foods.
Key points to remember
- healthy meal planning is an important part of diabetes management
- healthy eating for people with diabetes is the same as healthy eating for everyone
- there is no need for a child or young person to eat special foods
- regular physical activity is also important and benefits people of all ages
Healthy meal planning is an important part of diabetes management. Healthy eating for people with diabetes is the same as healthy eating for everyone. There is no need for a child or young person to eat special foods.
A dietitian specialising in diabetes will be able to help you and your child to work out an individual meal plan considering factors such as:
- nutritional requirements for growth and development
- daily routine
- food preferences
- (most important) matching the amount of carbohydrate with your child's insulin regimen or medications and physical activity
This will help to keep blood glucose levels steady and within the target range most of the time.
Carbohydrate is the best source of energy for the body. It is broken down into glucose in the bloodstream. Glucose is used as a fuel by the body, including the brain and the muscles.
Carbohydrates are found in the following foods:
- cereals and grains
(breakfast cereals, breads, crackers, rice, pasta, noodles)
- legumes and lentils
(baked beans, chickpeas, split peas, kidney beans, soya beans)
- starchy vegetables
(potato, kumara, corn, yam, parsnips, taro, green banana, cassava)
- natural sugars
(fruit, fruit juice, milk, honey, yoghurt)
- foods with added sugar
(jam, cakes, biscuits, ice cream, cordials, soft drinks)
Carbohydrate has the most direct influence on blood glucose levels. It is important to include carbohydrate foods at each meal (and snacks) to balance blood glucose levels. Your child/young person's dietitian can advise you on the appropriate amount of carbohydrate your child/young person needs.
The glycaemic index (GI) is a ranking of carbohydrate foods based on their immediate effect (compared to pure glucose) on blood glucose levels.
Some carbohydrate foods are digested slowly producing a gradual rise in blood glucose levels. These slow release carbohydrate (low GI or low glycaemic index) foods help to keep blood glucose levels steady. They help to provide sustained energy for your child/young person, especially during sporting activities.
Some examples of low GI foods are:
- heavy and dense wholegrain breads, such as Burgen®, Holsom's® 9 grain
- wholegrain or unrefined cereals that are high in fibre, such as rolled oats/porridge, muesli (choose unsweetened and untoasted), All Bran® , Special K®, Weetbix®
- pasta – white, wholemeal
- rice, such as Basmati, Doongara, Uncle Ben's® parboiled
- legumes and lentils, such as baked beans, chickpeas, split peas, kidney beans, haricot beans
- milk, yoghurt, low fat ice cream
- fruits such as citrus (oranges), stone (apricots, peaches, plums), cherries, apples, pears, dried apricots, prunes and apples
- vegetables, such as corn, yams, taro, green banana
Some carbohydrate foods are digested quickly and produce a rapid rise in blood glucose levels. They are called quick release or high GI foods.
A dietitian will be able to recommend the use of different types of carbohydrates to fit in your child/young person's meal plan and activities.
General guidelines on dietary management
The principles of the dietary management of type 1 and type 2 diabetes are similar. Following is general information only. Please see your dietitian for more details and individualised advice.
- have regular meal times every day
- do not skip meals
- try to stick to meal plan and times as much as possible
- include carbohydrate at each meal
- spread carbohydrate food evenly over the day
- a carbohydrate snack in between meals is important for children and young people who are on insulin injections, to avoid hypoglycaemia
- try to include low GI foods in meals and snacks
- choose a variety of food from the different food groups for growth and development
- limit intake of high fat (especially saturated fat) food by:
- choosing low or reduced fat dairy products and cheeses
- choosing lean cuts of meat (removing visible fat from meat and skin from chicken and poultry)
- limiting high fat snacks and takeaways, and processed meat
A low fat diet is not recommended for children under the age of 2 years
- limit intake of high sugar food such as sweets, cordial, powdered drinks, soft drinks and fruit juice
- remember 'treats' are not the same as 'snacks'. Foods that are high in fat, sugar and salt are for occasional treats only - don't give these as regular snacks. 'Treat' foods are potato chips, corn snacks, muesli bars, chocolate, sweets, cakes, sweet biscuits, pies and pastries
Type 1 diabetes
Learning how to work out the amount of carbohydrate from foods is important for the management of type 1 diabetes. Amongst the 3 main nutrients (carbohydrate, protein and fat) in food, carbohydrate has the most direct effect on blood glucose levels.
Understanding how to count carbohydrate will help your child to increase food choices and flexibility while maintaining blood glucose levels within the target range. There are 2 common ways to count carbohydrate:
- carbohydrate portions
- carbohydrate counting
A carbohydrate portion is a given serving of food which contains approximately the same amount of carbohydrate.
One portion of carbohydrate contains 15 grams of carbohydrate.
The dietitian will advise you on the appropriate amount of carbohydrate portion your child needs for each meal and snack. The choices of carbohydrate foods can be changed on different days as long as the total carbohydrate portions for each meal and snack is relatively consistent every day.
This is a method to count the total grams of carbohydrate in meals and snacks. A gram (g) is a unit used in measuring foods.
You will count the grams of carbohydrate in each of the foods your child eats, and then add them all up to work out the total carbohydrate (g) for the meal or snack. Your child's meal plan will specify the amount of carbohydrate needed for each meal or snack.
This method provides a more precise method of calculating carbohydrate in foods. Children or young people who are on insulin pumps need to count carbohydrates. Those who are on more intensive insulin regimes such as multiple daily injections benefit from this method.
Type 2 diabetes
The treatment goal for type 2 diabetes is to normalise blood glucose as much as possible. Lowering blood pressure and reducing high blood lipids must also be targeted, once optimal blood glucose control has been achieved.
First line therapy is weight reduction by making the following changes:
- healthy eating
- becoming more active and engaging in regular physical activities
- continuing to live a healthy lifestyle throughout adulthood
It is very important to involve the whole family/whānau in supporting your young person making healthy lifestyle changes.
Individualised advice is important
It is important that your child/young person sees a dietitian for individualised advice at least once a year to make sure the current meal plan is appropriate for optimal growth and development. A dietitian can also provide you with up to date information on the dietary management of diabetes and advice on changes to your child/young person's meal plan.
The Paediatric Society of New Zealand acknowledges the cooperation of the Starship Children's Hospital, Auckland District Health Board. The content on this page has been produced in collaboration with the National Clinical Network Children and Young People's Diabetes Services.