A child with diabetes benefits from the same kind of healthy
diet as people without diabetes. In fact, your whole family can eat
the same healthy meals together. Although kids with diabetes
don't have to follow a special diabetes diet, they may need to
pay more attention to when they eat and how much is on their
Some of the meal planning goals for children with diabetes are
the same as those for other kids: They need to eat meals that help
them have good overall health, normal
, and a
. But children with diabetes also have to balance their
carbohydrate intake with their insulin and activity levels to keep
their blood sugar levels under control. In addition, kids with
diabetes should also eat foods that help keep the levels of lipids,
or fats, in the blood (like
and triglycerides) in a healthy range. Eating this way can help
prevent some of the long-term health problems that diabetes can
Children with diabetes face the same food challenges as everyone
else - mainly, sticking with healthy eating habits over time. It
can be hard with so many temptations, so it's important to
prepare foods that your child enjoys. The meal plan you create may
vary depending on your child's diabetes management plan, but
with the help of your child's diabetes health care team, you
can tailor meal planning to your child's food preferences and
When you're planning and preparing meals for your child, you
have to know what's in the foods you're serving and eating.
It's easy to guess what some foods contain, but others are more
of a challenge. That's where food labels come in.
list a food's ingredients, nutritional information, and
One important thing to look at on a food label is carbohydrates,
which can have an impact on your child's blood sugar levels.
Usually, carbohydrates are clearly listed on food labels in grams.
There are two main forms of carbohydrates: sugars and starches.
Types of sugars include fructose (sugar found in fruit and some
(the main sugar in our bodies that's also found in foods like
cake, cookies, and soft drinks), and lactose (sugar found in milk
and yogurt). Types of starches include starchy vegetables like
potatoes, corn, and peas; grains, rice, and cereals; and
The body breaks down or converts most carbohydrates into
glucose, which is absorbed into the bloodstream. As the glucose
level rises in the blood, the
releases a hormone called
. Insulin is needed to move glucose from the blood into the cells,
where it can be used as a source of energy.
Regardless of the specific meal plan that your child's
doctor recommends (see below), it's important to be aware of
the carbohydrates in foods, so you can learn to balance
carbohydrate intake, activity levels, and insulin to achieve the
best possible control of your child's diabetes. You can figure
out your child's carbohydrate intake by checking the serving
size (amount) and the amount of carbohydrates per serving on the
food label and determining how many servings your child eats.
Here's an example:
Serving size: 1/2 cup (120 milliliters)
Carbohydrates per serving: 7 grams
Amount of food eaten: 1 cup (240 milliliters)
Grams of carbohydrates eaten: 14 grams (7 grams per serving
times 2 servings)
There is no one right amount of carbohydrates that your child
should eat. The amount of carbohydrates that a child needs per day
will depend on many things, including the child's age, size,
weight goal, exercise level, medications, and other medical issues.
The recommended carbohydrate intake is different for each child and
can even differ in the same child from day to day. Your child's
diabetes health care team will give you and your child guidelines
for carbohydrate intake as part of the meal plan.
You may also want to pay special attention to the sodium (salt)
content of the foods you serve. Sodium content is also listed on
food labels. Eating too much sodium is linked to the development of
high blood pressure, or
. Because some children with diabetes have hypertension, they may
need to keep sodium intake within the levels recommended by the
doctor to reduce the risk of high blood pressure problems. It's
a good idea to go easy on sodium, even if your child doesn't
It's also a good idea to pay attention to the amount of
and the type of fat that foods contain. Saturated fats,
cholesterol, and trans fats can all contribute to the development
of heart disease. People with diabetes are at greater risk of
developing heart disease, especially if they have abnormal levels
of lipids (fats) in their blood. Talk with your child's doctor
or dietitian about what kind of limits you may need to set on your
child's intake of fats.
Aside from these considerations, parents might check food labels
for the same reasons they do for themselves or other children. For
example, watching calories helps a person maintain a healthy
weight. It's also important to make sure that your family gets
enough vitamins, minerals, and
and eats a well-balanced diet in general.
Helping your child balance carbohydrate intake, physical
activity, and insulin to maintain good blood sugar control starts
with nutritious foods - the same ones everyone should eat for good
health. Try to make each meal a good balance of carbohydrates and
other nutrients, both for diabetes management and to make meals
satisfying. Here are some estimates to shoot for over the course of
- About 10% to 20% of the calories your child eats should come
. Try to select lean meats like chicken or beef.
- Roughly 25% to 30% of calories should come from
. Try to avoid foods with lots of trans and saturated fats (or
have your child eat them only in moderation).
- About 50% to 60% of the calories your child eats should come
. Encourage your child to eat lots of green and orange vegetables
every day - like carrots and broccoli. And choose vitamin-rich
brown rice or sweet potatoes instead of white rice or regular
You and your child will learn meal planning guidelines from the
diabetes health care team. Meal planning will be based on the foods
that your child usually eats. The team may also ask you and your
child to keep a detailed food diary for 3 days to get a good idea
of what your child likes to eat and what amounts of food your child
is accustomed to having.
The diabetes health care team may recommend other meal planning
guidelines, depending on your child's individual nutritional
needs. For example, if your child has a weight loss goal, then the
doctor or dietician may focus on controlling calories more
Three Common Approaches to Meal Planning
Although every child with diabetes will have a distinct set of
needs and an individualized meal plan to fit those needs, three
kinds of meal plans are commonly used: the exchange meal plan, the
constant carbohydrate meal plan, and the carbohydrate counting meal
Some people with diabetes, especially those who have just
developed the condition, use a food-balancing program called the
exchange meal plan
to guide what they eat each day. For this meal plan, foods are
typically divided into six groups: starch, fruit, milk, fat,
vegetable, and meat. The plan sets a serving size (amount) for
foods in each group, with each serving having a similar amount of
calories, protein, carbohydrates, and fat. This allows the person
flexibility in planning meals by exchanging, or substituting,
choices from lists of foods with similar nutritional content. The
number of exchanges (servings) from each food group recommended for
each meal and snack is based on the total number of calories the
person needs per day.
Your child's diabetes health care team can provide you with
exchange lists, which are also available through the American
Diabetes Association (ADA). This meal plan is particularly useful
for people with diabetes who are overweight or others who need to
pay closer attention to the amount of calories and nutrients they
eat each day.
The remaining two meal planning approaches are also based on
eating a balanced diet. But these two plans specifically focus on
matching the amount of insulin or diabetes medications a person
takes with the amount of carbohydrates they eat. With the
constant carbohydrate meal plan
, the person eats set amounts of carbohydrates in each meal and
snack. Then he or she takes insulin or other diabetes medicines at
consistent times and amounts each day to handle the rises in blood
sugar that occur with meals. Although it lacks flexibility, this
plan has the advantage of being simple to follow for people whose
food intake and physical activity levels are fairly consistent from
day to day.
Another option is the
carbohydrate counting meal plan
. Many people with diabetes now use carbohydrate (carb) counting to
estimate the amount of carbohydrates in the foods they eat at each
meal or snack. They then match their insulin dosage to that carb
amount. This plan is most useful for people who manage their
diabetes by taking a dose of insulin (as a shot or given through an
insulin pump) with each meal. This technique can help people
achieve better control of blood sugar levels as they manage their
diabetes. It also allows more flexibility because the person takes
insulin when meals are eaten, not at the same set times each
Keeping a written record of what your child eats can help you
and the diabetes team create and change your child's dietary
plan as needed. You might continue to track your child's
carbohydrate intake alongside blood sugar readings in a blood
glucose record to see how well food and insulin are being balanced.
Kids can keep track while they're at school or away from home.
If you need to make insulin adjustments, this written record can
help you understand why and help you decide how much and at what
time your child should have the new dosage.
It can also help you plan if you keep a few quick references
handy, such as charts that show portion sizes and how many
carbohydrates various foods contain. Your child's diabetes
health care team or a nutritionist can supply this information, and
the ADA offers it as well.
If you ever feel stuck while you're planning nutritious,
well-balanced meals, inspiration is never far. Cookbooks and recipe
websites offer lots of healthy
- many of which you can prepare quickly and easily. With diabetes
knowledge and the right tools, you'll be prepared to help your
child eat right for good health.
Steven Dowshen, MD
Nancy Gugerty, RN, RD, CDE
Date reviewed: September 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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