Nutritional tips for children with type 1 diabetes

While a type 1 diabetes diagnosis in a child can be overwhelming, the good news is the right diet goes a long way to successfully manage the condition. We asked dietician and ADSA spokesperson, Nasreen Jaffer, for her top nutritional tips. By Tammy Jacks

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“Finding out 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,” explains Nasreen.

“However, 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,” she adds. In fact, it’s often the small changes that have the biggest effect on glycaemic control.

ALSO SEE: Type 1 diabetes in children – what you need to know

Seeking 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, 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.

Healthy eating is key

“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 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”, Nasreen adds.

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 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.

Ensure she eats plenty 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.

Encourage her to eat beans, peas, lentils and soya regularly  

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.

ALSO SEE: Spicy lentil burgers

Include plenty of lean protein in her 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.

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 risk of heart disease 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 compared to saturated fats.

Monounsaturated fats such as canola oil, olive oil and avocados are also healthier fats compared to saturated fats. Therefore, aim to increase your child’s intake of polyunsaturated and monounsaturated fats by reducing or replacing saturated fats.

Use salt sparingly  

Children don’t need a lot of salt in general. A high intake of salt (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 has a high salt content.

Let her drink lots of clean, safe water  

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 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.

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.

More about the expert:

Nasreen Jaffer is a registered dietitian in private practice at Nasreen Jaffer and Associates in Rondebosch, Cape Town, where she consults with patients with a variety of nutritional goals and/or challenges. She is also a spokesperson for ADSA (The Association for Dietetics in South Africa) and is registered with the Discovery Vitality Dieticians Network.

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