Diabetes: How Kids Can Eat Healthy

My brother has diabetes.  He developed it when he was just 7 years old, so it dominated his childhood and my teenage years.  It had major impacts on our family.  For families with a diabetic child, it can cause major changes in the family diet.  Here are some ways to eat healthy with diabetes:

Types of Diabetes

There are two types of diabetes.  Type 1 diabetes (which used to be known as juvenile onset diabetes) is when the pancreas simply stops producing insulin.  There is no cure for Type 1 diabetes and diabetics with this form of the disease have to take insulin injections for the rest of their lives (or until a cure is found).  Diet and insulin injections are the best way to manage Type 1 diabetes.

Type 2 diabetes used to be known as adult onset diabetes because it is strongly associated with obesity and used to occur predominantly in older adults.  Not so today.  With so many children today overweight and so many children consuming high sugar foods and refined carbohydrates that spike blood sugars, Type 2 diabetes is now increasingly common among children and can no longer be called “adult onset diabetes.”  With Type 2 diabetes, the pancreas still produces insulin but the body doesn’t regulate it well.  Type 2 diabetes is not as stark as Type 1 diabetes.  Indeed, it is more of a continuum.  Some people have Type 2 diabetes so mildly that it can be managed entirely by dietary modifications.  People who have a more severe form can take medication and people who have a very severe form need insulin injections like Type 1 diabetics do.

No matter how severe the diabetes or what Type, diet is a crucial part of any management program.  Of course you should consult you’re doctor before embarking on a particular dietary program, as I am not a doctor, nor have I even played one on TV (although I was once on an episode of Law & Order: Criminal Intent, which is fitting because I am actually a lawyer haha!).  My advice regarding diet for diabetics is meant to be practical and helpful, not the be all and end all of diabetes dietary requirements!!

Impact of diet on diabetes

Diet can have an enormous impact on diabetes.  Insulin is a hormone our bodies produce that regulates blood sugar levels.  Blood sugar levels that are too high or too low can cause serious illness, coma, and even death, so managing diabetes effectively is really important.  Unfortunately, much of the food kids eat today is processed and full of sugar (it is hidden in all sorts of things you wouldn’t expect).  Kids also eat a lot of refined carbohydrates, such as white rice, white flour, and white potatoes – I like to say, “White flour, white potatoes, and white rice: If it’s white, it isn’t nice!”  Carbohydrates are converted into sugars by the body so it can use them as fuel, but refined carbohydrates are converted into sugars very quickly and simply, so they flood the system.  Think about it: eat one serving of white bread and compare how long you feel full to when you eat one serving of whole grain steel cut oatmeal.

In fact, in cases of Type 2 diabetes diet can even reverse diabetes entirely, just as diet can reverse obesity.  This has been tested in animals and also shown in scientific peer-reviewed studies to work in humans (especially effective if exercise is included).  This works because a healthy diet reduces obesity and heart disease risk factors – even in children.

Diets for Diabetic Kids

The Internet is full of different diets to help reduce or reverse diabetes.  As an adult, you can afford to buy into the starvation diet, but even if it is endorsed by a reputable university’s biomedical department, a starvation diet can be dangerous for children, whose bodies are still developing.  Do not starve your children!

However, the concept still works for kids.  Other studies (see above) show that reducing calorie intake can slow, stop, or even reverse diabetes development.  This is because reducing caloric intake has a twofold benefit for diabetics.  Firstly, if done in a healthy and balanced way, it normalizes blood sugar, avoiding blood sugar spikes and making blood sugar regulation easier on the body.  Secondly, it reduces weight and reducing obesity reduces the incidence of diabetes.

Another demonstrated dietary fact is that diabetics should reduce fat intake.  In more than one of the studies I cited above, fat and especially fatty liver played a stark role in the development and reversal of diabetes.  This is why the healthy vegan diet kids in the recent heart disease study was so effective in reducing heart disease risk factors in children: It was very low fat.

That said, there are three commonly endorsed diets for diabetics, all of which can be healthfully used by children:

The Plate Method

The Plate Method is the diet for diabetics that is currently recommended.  It calls for 50% of the plate to be covered with non-starchy vegetables, 25% with starchy vegetables, and 25% with protein, as well as a serving of fruit and a serving of milk on the side for each lunch and dinner meal.  Of course, the efficacy of any diet like this relies on making good food choices. Non-starchy vegetables such as asparagus or broccoli should be cooked in a healthy way, like steaming, roasting, or stir fry, not doused in sauces and oils.  Not all starchy foods are created equal.  Whole grains like brown or wild rice and quinoa are preferable to refined grains like white rice or white bread.  Starchy vegetables like zucchini, peas, and parsnips are more nutritious than white potatoes (and also have more flavor, reducing the need for additives like butter and oil).  Non-fat protein choices like tofu or seitan will always be better than an animal product even if it is low in fat, due to the way in which the body metabolizes animal fats, and also due to the benefit of fat reduction in diabetic diets.  For children, consider serving the fruit during snack times rather than during meal times, thus eliminating the need for kids to have yet more calories in their diets during the day.  For the milk, I recommend making your own brown rice milk or buying oat or almond milk.  If done properly, this kind of diet is incredibly healthy.

A sample lunch would be:

• 1 cup brown rice milk
• Sandwich of whole grain bread, lots of hummus (for protein), and roasted spring vegetables or salad vegetables
• Side of raw non-starchy vegetables (such as cucumbers, mushrooms, and capsicum) with some more hummus to dip them in.
• 1/2 cup strawberries for morning snack
• 1 small banana for afternoon snack

A sample dinner would be:

• 1 cup brown rice milk
• Stir fry of non-starchy vegetables like asparagus, broccoli, cauliflower, and spinach with tofu over brown and wild rice mix

Diabetic Exchange Diets

There was a time when this method was very popular, but compared to the Plate Method, it seems like a bit of a pain to me.  Foods are divided into six categories: starch, meat (there are no vegan meat substitutes), non-starchy vegetables, fruit, milk, and fats.  Together with a dietician each individual will be given a number of servings to have from each category each day.  This method is easier in a way because it is easier to measure out servings, but it also basically forces adherents to eat a lot of animal protein.  This eliminates the potential benefits of following diets now shown to be effective for weight loss.

Carbohydrate Counting

This method counts each major carbohydrate source as one serving (15 g) of carbohydrate.  The list of carbohydrate sources includes starches, fruits, milk, and sweets.  Of course this does not necessarily lend itself to be the most healthy diet, although it does allow a lot more leniency for kids who won’t take well to being told they cannot have dessert.  That’s because if, say, a cookie counts as one carbohydrate, kids can choose to fill up their carbohydrate quota with unhealthy sources of carbs.  This type of diet requires a lot of parent monitoring because its permissiveness creates a sort of temptation for kids.  It also does not limit sources of other things affecting kids’ diet and weight.  For instance, fat and meat intake are not measured, so a child could eat lots of steak and then carbohydrate count for dessert, which would not be a healthy diet at all.  Of course, a parent who is conscious of their child’s choices and is committed to making good food choices and to dedicating extra time to their child’s diet can make it work.  But carbohydrate counting is definitely the most time consuming of the three methods.

Tips and Advice

• Feed the whole family the same meals as the diabetic child is eating.  Diabetic children should be eating very healthfully, which will be good for the whole family.  Also, if a child is overweight, it is likely that other family members are also not at their ideal weights and can benefit from a healthy weight loss diet.
• Don’t starve your kids, but do do portion control.  Don’t allow kids to eat as much as they want.  Overeating is often a contributor to obesity, which can lead to the onset of diabetes.
• Reduce the amount of packaged and processed foods in your child’s diet.  Even so-called diabetic foods are not necessarily healthy.  Feeding your diabetic child sweets made with artificial sweeteners can cause other health problems.
• Read nutrition labels.  You may be surprised to see how many carbohydrates are in your favorite foods and snacks.  Be aware that the serving size on a package may not match the serving size of one serving if you are doing an exchange diet.
• Reduce the amount of fat – fat consumption increases risk of heart disease and diabetics are much more at risk of developing heart disease.
• Spread meals out during the day.  For instance, breakfast, morning snack, lunch, afternoon snack, and dinner.  This will help keep your child from feeling too hungry and will also help the body metabolize sugars and nutrients more evenly.
• Get your child active!  Diet can go a long way to reducing obesity and diabetes management, but exercise and burning up of some of that energy is also really important.  This is a good time to get your child involved in an activity that gets them moving, whether that is an organized team sport or just neighborhood games.  My gym even offers classes for kids!  You can also make exercise a family activity – going for walks, family bike rides, or hikes in local nature areas are great ways to bond as a family while increasing the health of everyone in the family!

I hope these tips make it easier to find a healthy diet for your diabetic or pre-diabetic child!  Together, we can manage diabetes and maybe even reverse it!

For More Information:

American Diabetes Association: www.diabetes.org

Academy of Nutrition and Dietetics: www.eatright.org

National Diabetes Education Program: http://ndep.nih.gov