Diabetes Mellitus and Nutrition, Pediatric

• Manage blood glucose and prevent low blood glucose (hypoglycemia).
• Prevent your child from developing complications of diabetes.

What can affect my child's meal plan?

• The calories your child needs.
• The medicines your child takes.
• Your child's weight.
• Your child's blood glucose, blood pressure, and cholesterol levels.
• Your child's activity level.
• Other health conditions your child has, such as heart or kidney disease.

How do carbohydrates affect my child?

• Help your child track the carbs that he or she eats. You and your child can do this by reading food labels and learning the standard serving sizes of foods.
• Know how many carbs your child can safely have in each meal, as directed by the health care provider or dietitian. This amount is different for every person.

What are tips for following this plan?

Reading food labels

• If your child is old enough, teach him or her to read the Nutrition Facts label on packaged foods and drinks.
• Start by checking the serving size on the label. The number of calories and amount of carbs, fats, and other nutrients listed are based on one serving of the item. Many items contain more than one serving per package.
• Check the total grams (g) of carbs in one serving.
• Check the number of grams of saturated fats and trans fats in one serving. Choose foods that have a low amount or none of these fats.
• Check the number of milligrams (mg) of salt (sodium) in one serving. Most children should limit total sodium intake to less than 2,300 mg a day. Follow instructions from the health care provider or dietitian about how much sodium your child should have each day.
• Always check the nutrition information of foods labeled as "low-fat" or "nonfat." These foods may be higher in added sugar or refined carbs and should be avoided.
• Talk with the dietitian to identify daily goals for nutrients listed on the label.

Shopping

• Avoid buying canned, pre-made, or processed foods. These foods tend to be high in fat, sodium, and added sugar.
• Shop around the outside edge of the grocery store. This is where you will most often find fresh fruits and vegetables, bulk grains, fresh meats, and fresh dairy products.

Cooking

• Use low-heat cooking methods, such as baking, instead of high-heat cooking methods, such as deep frying.
• Cook using healthy oils, such as olive, canola, or sunflower oil.
• Avoid cooking with butter, cream, or high-fat meats.
• Add extra vegetables into meals when possible, such as in stews, chili, and stir-fry dishes.

Meal planning

• Have your child:
  • Eat meals and snacks at the same times every day.
  • Eat foods that are high in fiber, such as fresh fruits, vegetables, beans, and whole grains.
  • Eat 4–6 oz (112–168 g) of lean protein each day, such as lean meat, chicken, fish, eggs, or tofu. One ounce (oz) (28 g) of lean protein is equal to:
    • 1 oz (28 g) of lean meat, chicken, or fish.
    • 1 egg.
    • ¼ cup (62 g) of tofu.
  • Eat some foods each day that contain healthy fats, such as avocado, nuts, seeds, and fish.
• With some extra planning and help from a dietitian and health care provider, you can include treats and desserts as part of your child's meal plan. Plan ahead with your child for times when he or she can have treats, such as holiday parties.
• Make sure that your child knows what healthy portion sizes are. A portion size refers to how much food your child eats at a time.
  • Many restaurant meals contain portion sizes that are too large for a child. Plan ahead and view restaurant menus on websites ahead of time.
  • Avoid buffets. In buffets, it is difficult to know the nutritional content and portion sizes of food.
• Work with your child's school to share and receive the information that you need to help your child make healthy food choices. This may include making a written care plan (504 plan) for managing your child's diabetes at school.
• It can be easier for your child to eat healthy foods at school when:
  • Your family also makes changes at home.
  • Your child eats lunch with friends who also make healthy choices.

Snacking

• Have your child avoid going long periods of time without eating. Make sure your child always has a snack available.
• To increase your child's fruit and vegetable intake, keep cut-up fruits and vegetables available in the refrigerator.
• Some healthy snack ideas include:
  • Celery with peanut butter.
  • Cut-up vegetables, such as carrot sticks, with hummus.
  • Whole-grain crackers with cheese or peanut butter.

What foods should my child eat?

Fruits

Berries. Apples. Peaches. Plums. Apricots. Papayas. Mangoes. Grapes. Pomegranates. Cherries. Kiwi.

Vegetables

Leafy greens, including lettuce, spinach, kale, chard, collard greens, mustard greens, and cabbage. Cauliflower. Green beans. Peppers. Cucumbers. Tomatoes. Brussels sprouts.

Grains

Whole grains such as whole-wheat or whole-grain bread, crackers, tortillas, cereal, and pasta. Unsweetened oatmeal. Barley. Quinoa. Brown rice.

Meats and other proteins

Lean meats. Poultry without skin. Seafood. Shellfish. Tofu. Nuts.

Dairy

Low-fat or fat-free dairy products such as milk, yogurt, and cheese.

The items listed above may not be a complete list of foods and beverages your child can eat and drink. Contact a dietitian for more information.

What foods should my child avoid?

Fruits

Fruits canned with syrup.

Vegetables

Canned vegetables. Frozen vegetables with butter or cream sauce.

Grains

Refined white flour and flour products such as bread, pasta, cereals, and snack foods. Avoid processed foods.

Meats and other proteins

Fatty cuts of meat. Poultry with skin. Breaded or fried meats. Processed meat. Avoid saturated fats.

Dairy

Full-fat yogurt, cheese, or milk.

Beverages

Sweetened drinks, such as soda.

The items listed above may not be a complete list of foods and beverages your child should avoid. Contact a dietitian for more information.

Questions to ask a health care provider

• Do my child and I need to meet with a certified diabetes care and education specialist?
• Do my child and I need to meet with a dietitian?
• What number can I call if I have questions?
• When are the best times to check my child's blood glucose?

Where to find more information:

• American Diabetes Association: diabetes.org
• Academy of Nutrition and Dietetics: eatright.org
• National Institute of Diabetes and Digestive and Kidney Diseases: niddk.nih.gov
• Association of Diabetes Care & Education Specialists: diabeteseducator.org

Summary

• Healthy eating habits are very important for diabetes care. Your child's blood sugar (glucose) levels are affected by what he or she eats and drinks.
• Eating healthy foods in the right amounts, at about the same times every day, can help manage blood glucose and prevent diabetes complications.
• Work with your child's school to share and receive the information that you need to help your child make healthy food choices. This may include making a written care plan (504 plan) for managing your child's diabetes at school.
• Have your child eat meals and snacks at the same times every day. Make sure that your child always has a snack available between meals.