Nutritional needs for children with diabetes are the same as children without diabetes. The difference lies in keeping blood sugar levels within a normal range, and meal planning can help. With challenges like picky eating, changing appetites, busy schedules, sports and long school days, knowledge of carbohydrate counts of foods is essential. A May 2009 article published in "Diabetes Educator" found that the diets of children with type 1 diabetes often do not meet recommended guidelines. The authors noted too much processed food and low intake of fruits, vegetables and fiber. Luckily, there is a variety of healthy foods children can eat to satisfy their appetites and nutritional needs, maintain good blood sugar control and keep them feeling like kids.
Dairy foods such as cheese, yogurt and milk are packed with nutrients kids need, including calcium, potassium and protein. Many dairy foods are also fortified with vitamin D. Nonfat, low-fat and full-fat dairy products vary in carbohydrates, which makes label reading essential. Cheese is low in carbohydrates, with less than 1 g in a mozzarella cheese stick. An 8-ounce glass of 2 percent milk contains 13 g. Popular kids' yogurts can be high in sugar, but yogurt can be a healthy snack. Adding a child's favorite fruit to plain yogurt helps limit added sugar. The 2015-2020 Dietary Guidelines for Americans recommends low-fat or nonfat dairy as part of a healthy eating plan after age 2, to limit intake of saturated fats. A diet low in saturated fat is recommended for children with diabetes, according to the American Diabetes Association (ADA) due to an increased risk of heart disease.
All fruit is good fruit and should be included in the diet of a child with diabetes. One small fruit, such as an apple, clementine orange or peach, contains approximately 15 g of carbohydrate. A cup of watermelon, cantaloupe, raspberries or another cut fruit typically contains about the same amount. Two tablespoons of dried fruit with no sugar added, such as dried cranberries, tart cherries or raisins, also have roughly 15 g of carbs. If opting for canned or frozen fruit, choose those with no added sugar or packed in water instead of syrup. While juice does not offer all of the nutrients and fiber that a child can get from whole fruit, 100 percent juice with no added sugar can be included in a healthy diet in limited amounts. Adding fruit to yogurt, smoothies and oatmeal and cutting it into fun shapes can be helpful if your child resists eating fruit.
Picky eating can make it difficult for kids to get enough vegetables. Cucumbers, bell peppers, celery, broccoli and cauliflower can be cut into small pieces, making them excellent choices for snacks. Fresh vegetables can be paired with a kid-friendly dips, such as hummus, guacamole or salsa. Most vegetables have a fairly low carbohydrate count. For example, a cup of cut cucumber has less than 4 g of carbohydrate, and a cup of cherry tomatoes has about 6 g. According to the ADA, unless more than 2 cups of raw vegetables or a cup of cooked are eaten, vegetables are not counted in overall carb totals because the high amount of fiber typically means these foods have minimal effect on blood sugar levels. The exception is starchy vegetables, which contain significantly higher levels of carbohydrate.
Starchy vegetables -- such as potatoes, corn, butternut squash and peas -- contain a higher carbohydrate count than other vegetables, about 15 g per 1/2-cup serving. For this reason, they are treated differently than other vegetables in nutrition planning for children with diabetes. Beans and lentils also contain about 15 g of carb per 1/2 cup and provide much-needed soluble fiber for children. Soluble fiber slows digestion, so it helps prevent large spikes in blood sugar after eating. Adding refried beans to a whole-wheat tortilla, black beans to soup or chickpeas to pasta can be a fun way for children to try more beans.
Meats do not contain carbohydrates, so they do not raise blood sugar. Choosing lean chicken, beef, turkey, fish and pork helps keep saturated fat intake low. Plant-based protein foods contain carbohydrates in varying amounts. If a child has no allergies, nuts and nut butters are healthy additions to his diabetes diet. Nuts contain relatively low levels of carbs per serving and provide healthy fiber. Tofu is another good protein option for diabetic children. Tofu contains about 2 g of carbs per 3-ounce serving, but it is lower in calories and saturated fat than many animal proteins. Reduced-fat cheeses and cottage cheese, along with eggs, are other protein choices that can add variety to meals and snacks for children.
Grains provide carbs and variable amounts of fiber. Whole grains, which are higher in fiber than highly processed grains, should make up at least half of the total daily grain intake. Oatmeal, popcorn, quinoa, whole-grain breads, pasta and cereals are all good options. Pairing a whole grain such as quinoa with a child's favorite food, such as chicken, can help increase whole-grain intake. A slice of whole-wheat bread, 2 cups of air-popped popcorn and 5 whole-wheat crackers contain approximately 15 g of carbs. A January 2016 "Nutrition Journal" study report concluded that when whole grain intake increased, overall diet quality increased in both adults and children. It's easy to make the switch from white to whole-grain crackers, tortillas, English muffins and rolls to add more whole grains to a child's diet.
Sweets and Other Considerations
Kids with diabetes want to be like other kids. One aspect of this is occasionally allowing a child to have a serving of sweets. However, planning is essential. Sweets must be included in the daily carbohydrate count and blood sugar monitored closely.
The ADA recommends an individualized diet for all children with diabetes, whether they have type 1 or type 2. Dietary modifications may be needed depending on a child's weight, growth, age and activity level. For example, children who play sports may require extra snacks to prevent hypoglycemia. On the other hand, children who are overweight may need a meal plan to help with weight management. Always speak with a medical provider or a registered dietitian if questions arise about which foods are appropriate for a child with diabetes. Timing and planning of meals are essential tools in controlling a child's blood sugar levels and ensuring they grow up healthy.