Type 1 diabetes: Nutritional tips for children

Hearing that your child has type 1 diabetes might be overwhelming at first, because it often requires a number of dietary changes, along with tight blood sugar level control. The good news is you can make these changes gradually, and still ensure your child enjoys her meals, snacks, and treats – within the boundaries of successfully managing her blood sugar levels. In fact, it’s often the small changes that have the biggest effect on glycaemic control.

We chat with Nasreen Jaffer, a registered dietitian in private practice at Nasreen Jaffer and Associates in Rondebosch, Cape Town, for her top tips:

Turn to a dietician for advice

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 how certain foods react in the body, a dietician 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.

Healthy eating is key to managing diabetes

There’s no such thing as a diabetic diet, it’s all about healthy eating. 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 following Food-Based Dietary Guidelines have been officially adopted by the National Department of Health. 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.

Here are some key points from the guidelines:

Let your child enjoy a variety of 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 also 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
• Wholewheat pasta

Top tip: 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.

The importance of vegetables and fruits each day   

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 may be 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 protein quality of the meal. They’re also packed with fibre to keep your child regular and are a budget-friendly source of cholesterol-free dietary protein.

Include plenty of lean protein in your child’s diet

This includes chicken, fish, meat, milk, or eggs, which 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. 

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.

Always read labels carefully

An easy way to spot if a product contains 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.