Tackling type 1 diabetes in children

Finding out your child has type 1 diabetes might be overwhelming at first because it often requires several dietary changes, along with tight blood sugar level control. However, you can gradually make these changes and ensure your child enjoys her meals, snacks, and treats. We chatted with dietician and ADSA spokesperson Nasreen Jaffer for her top nutritional tips.

Speak to an expert

Rather than trying to figure it all out on your own, it’s a good idea to speak to a registered dietician with experience in diabetes management. Besides educating you on how certain foods react in the body, she will take factors like your culture, religion, child’s age, other health conditions, and family dynamics into account to determine the best approach for both your child and the family.

Forget “diabetic diets”

“There’s no such thing as a diabetic diet; it’s all about healthy eating,” says Nasreen. There’s no need to prepare separate meals for your child, and you don’t need to break the bank buying special foods that she may or may not eat.

The National Department of Health has officially adopted the following Food-Based Dietary Guidelines. They are designed to help manage body weight, blood glucose control, blood pressure, and blood cholesterol levels. These guidelines also help to prevent complications and improve quality of life.

Let your child enjoy various foods: No single food or meal can provide your child’s body with all the nutrients it needs. However, unhealthy eating habits, like skipping meals, can lead to an unhealthy eating pattern as your child gets older. Try to ensure your child eats regularly and has 3 meals and 2 snacks a day. Make starchy foods the basis of most meals. Starchy foods are a rich source of carbohydrates, which supply the body with energy and affect blood glucose levels. All carbohydrate foods are digested to produce glucose, but they do so at different rates – some slow, some fast.

A note on the Glycaemic Index:  The Glycaemic Index or GI is a way of describing how a carbohydrate-containing food affects blood glucose levels. Foods with a low GI raise blood glucose slower than foods with a high GI. Therefore, starchy foods, making the basis of most meals, should have a low glycaemic index and be rich in fibre. Good examples include unrefined maize meal, oats, high fibre breakfast cereals, wholewheat bread, brown rice, and wholewheat pasta. It’s also important that equal amounts of starchy foods are eaten at breakfast, lunch, and supper, rather than having large amounts in one meal.

Vegetables and fruits:  All types of vegetables and fruit can be eaten as part of a healthy eating plan, preferably with the peel on and raw or lightly cooked. Fresh fruit is preferable to dried fruit and maybe eaten as part of main meals and/or snacks. The motto is to “strive for 5”. In other words, aim for 3 vegetable portions and 2 pieces of fruit a day. Fruit juices should be limited as they’re concentrated sources of carbohydrates and may cause a rapid rise in blood glucose levels.

Beans, peas, lentils, and soya: While these aren’t generally staple foods for kids, they’re exceptionally healthy choices for those with type 1 diabetes. This is because they have a low glycaemic index, which helps to keep blood glucose levels stable and to regulate appetite. Try to get your child to have these foods at least once a week, either to replace meat dishes or combined or mixed with meat to enhance the meal’s protein quality. They’re also packed with fibre to keep your child regular and are a budget-friendly source of cholesterol-free dietary protein.

Lean protein:  Chicken, fish, meat, milk, or eggs should be eaten daily. These are rich in protein, calcium (dairy products), iron (meat products and eggs), and vitamin B12 but can also be high in fat and cholesterol. Good food choices include lean meat cuts, skinless chicken, fresh or tinned fish, eggs, and low-fat dairy products. 

Use salt sparingly:  Children don’t need a lot of salt in general. A high salt intake (sodium) has been linked to high blood pressure and increased risk for heart disease and stroke. Make use of herbs, garlic, onions, and tomatoes instead of salt for flavour. Minimise the intake of foods like biltong, bacon, snoek, pickled fish, salted nuts, salted popcorn, and chips, which have a high salt content.

Water intake:  Diabetics should aim to drink at least 6-8 cups of water a day, but speak to your child’s doctor, as this may vary depending on her weight. Increase her water intake if she’s experiencing diarrhoea or vomiting.

Be active: In addition to a healthy diet, regular exercise is important for your child’s overall health. Children with type 1 diabetes should participate in 60 minutes of moderate exercise daily. This can include brisk walking, dancing to vigorous music, running, jumping rope, or riding a bike.

Read labels carefully:  An easy way to spot a product containing sugar is to look at the ingredients list. If sugar is in the first three ingredients, the product is high in sugar. By law, manufacturers have to list ingredients from highest to lowest concentration.  It’s also a good idea to read food labels for added sugars. These include corn syrup, dextrose, dextrose syrup, fructose, fructose sugar, glucose, glucose syrup, honey, invert sugar, lactose, maltose, maltose syrup, sucrose, sucrose syrup, sugar, and xylose.

How to handle sugar intake

Sugars (including fructose powder and high fructose corn syrup) should ideally be less than 5% of your child’s total energy intake per day. This equates to the sugar found in commercial products such as sauces, without adding additional sugar to her diet. Sugar can cause blood glucose levels to rise quickly and should be avoided. However, products labelled “diabetic”, “no added sugar”, and “low sugar”, aren’t essential. Many of these products have a high fat and energy content, and should be used with caution, explains Nasreen.

Tips to reduce your child’s intake of added sugar:

• Choose snacks that are lower in added sugar. Offer treats less often.
• Offer sugar-coated cereals less often.
• Avoid adding sugar to cooked vegetables.

Watch your child’s fat intake

Fats have the highest caloric content of all foods. Eating too much can lead to weight gain, poor diabetes control, and increase blood fats such as cholesterol and triglycerides. On the other hand, small amounts of healthier fats that add flavour to your child’s food may improve her health and reduce her heart disease risk as she gets older. Therefore, the type of fat you let her eat is important, as well as the amount. Saturated fat is found in animal foods like meat, milk, butter, and cheese and should make up less than 10% of total energy intake. Polyunsaturated fats such as margarines and sunflower oils and the fat found in oily fish such as mackerel, sardines, salmon, and fresh tuna are better fats than saturated fats. Monounsaturated fats such as canola oil, olive oil, and avocados are also healthier fats than saturated fats. Therefore, aim to increase your child’s intake of polyunsaturated and monounsaturated fats by reducing or replacing saturated fats.