Meal Plans and Diabetes

Meal Planning Goals

Kids with diabetes benefit from a healthy diet the same as everyone else. Although kids with diabetes don't have to follow a special diabetes diet, they may need to pay more attention to when they eat and how much is on their plates.

Meal planning goals for kids with diabetes often are the same as those for other kids: They need foods that help them have overall good health, normal growth, and a healthy weight.

But kids with diabetes also have to balance their intake of carbohydrates (carbs) with their insulin and activity levels to keep blood sugar levels under control. And they should eat foods that help keep blood levels of lipids (fats like cholesterol and triglycerides) in a healthy range. Doing so can help prevent some of the long-term health problems of diabetes.

Food Labels

You need to know what's in the foods you're serving and eating. Look to food labels to find a food's ingredients, nutritional information, and calories.

Check information on carbs, which can affect blood sugar levels. Usually, they're clearly listed on food labels in grams. The two main forms of carbs are sugars and starches. Types of sugars include:

• fructose (sugar found in fruit and some baked goods)
• glucose (the main sugar in our bodies that's also found in foods like cake, cookies, and soft drinks)
• lactose (sugar found in milk and yogurt)

Starches include vegetables like potatoes, corn, and peas; grains, rice, and cereals; and breads.

The body breaks down or converts most carbs into glucose, which is absorbed into the bloodstream. As the glucose level rises, the pancreas releases the hormone insulin. Insulin moves glucose into the cells to be used as an energy source.

Regardless of the specific meal plan that your doctor recommends, it's important to be aware of carbs. This helps you balance carbohydrate intake, activity levels, and insulin to achieve the best possible diabetes control.

To figure out your child's carb intake, check the serving size and the amount of carbs per serving on the food label and determine how many servings your child eats.

Here's an example:

• serving size: ½ cup (120 milliliters)
• carbohydrates per serving: 7 grams
• amount of food eaten: 1 cup (240 milliliters)
• grams of carbohydrates eaten: 14 grams (7 grams per serving x 2 servings)

The "Right" Amount?

There is no single right amount of carbohydrates that your child should eat. The recommended carb intake is different for each child and can even differ in the same child from day to day. The diabetes health care team will provide guidelines as part of the meal plan.

Also look at the sodium (salt) content on food labels. Eating too much sodium is linked to high blood pressure (hypertension). Some kids with diabetes have hypertension, and may need to keep sodium intake within doctor-recommended levels to lower their risk of related problems. It's always wise to go easy on sodium, even if your child doesn't have hypertension.

Also pay attention to the amount of fat and the type of fat. Saturated fats, cholesterol, and trans fats can contribute to the development of heart disease. People with diabetes are at greater risk for heart disease, especially if they have abnormal blood lipid levels. Ask your doctor or dietitian whether your child should limit fats.

Meal Planning

Try to make each meal a good balance of carbs and other nutrients, both for diabetes management and to make meals satisfying.

Here are some things to keep in mind:

• About 10% to 20% of the calories your child eats should come from protein. Try to select lean meats like chicken or beef.
• Roughly 25% to 30% of calories should come from fat. Avoid foods with lots of trans and saturated fats (or serve them only in moderation).
• About 50% to 60% of the calories your child eats should come from carbs. Encourage your child to eat lots of green and orange vegetables every day — like carrots and broccoli. And choose vitamin-rich brown rice or sweet potatoes instead of white rice or regular potatoes.

The diabetes health care team will provide meal planning guidelines based on the foods that your child usually eats. The team might ask you and your child to keep a detailed food diary for 3 days to get an idea of what your child likes and in what amounts.

The team may recommend other meal planning guidelines depending on your child's individual nutritional needs. For example, if your child has a weight loss goal, then the doctor or dietician might focus more closely on controlling calories.

Three Common Approaches to Meal Planning

Three kinds of meal plans are commonly used:

1. the exchange meal plan
2. the constant carbohydrate meal plan
3. the carbohydrate counting meal plan

In the exchange meal plan, foods are divided into six groups: starch, fruit, milk, fat, vegetable, and meat. The plan sets a serving size for foods in each group. Each serving has a similar amount of calories, protein, carbs, and fat. This allows flexibility in planning meals by exchanging, or substituting, choices from lists of foods with similar nutritional content. The number of exchanges (servings) from each group recommended for each meal and snack is based on the total number of calories the person needs per day.

The diabetes health care team can provide you with exchange lists. This meal plan is particularly useful for people with diabetes who are overweight or others who need to pay closer attention to the amount of calories and nutrients they eat each day.

The other two meal planning approaches also are based on eating a balanced diet but specifically focus on matching the amount of insulin or diabetes medicines a person takes with the amount of carbs they eat. With the constant carbohydrate meal plan, the person eats set amounts of carbs in each meal and snack, then takes insulin or other diabetes medicines at set times and amounts each day to handle the rises in blood sugar. Although it lacks flexibility, this plan has the advantage of being simple to follow for people whose food intake and physical activity levels are fairly consistent from day to day.

Many people with diabetes now use the carbohydrate counting meal plan to estimate the amount of carbs in the foods they eat at each meal or snack. They then match their insulin dosage to that carb amount. This plan is most useful for those who manage their diabetes by taking a dose of insulin (as a shot or given through an insulin pump) with each meal. This technique can help people achieve better control of blood sugar levels as they manage their diabetes. It also allows more flexibility because the person takes insulin when meals are eaten, not at the same set times each day.

Helpful Tools

Keeping a written record of what your child eats can help you and the diabetes team create and change the dietary plan as needed. You might continue to track carbohydrate intake alongside blood sugar readings in a blood glucose record to see how well food and insulin are being balanced.

Kids can keep track while they're at school or away from home. If you need to make insulin adjustments, this written record can help you understand why and help you decide how much and at what time your child should have the new dosage.

It can also help you plan if you keep a few quick references handy, such as charts that show portion sizes and how many carbs various foods contain. The diabetes health care team or a dietitian can supply this information too.

If you ever feel stuck while you're planning nutritious, well-balanced meals, inspiration is easy to find. Cookbooks and recipe websites offer lots of healthy meal suggestions — many of which you can prepare quickly and easily. With diabetes knowledge and the right tools, you'll be prepared to help your child eat right for good health.