Nutritional recommendations for type 1 diabetes in children
Parents need to learn to manage the food intake of the child with type 1 diabetes while keeping their condition in mind without making the kid feel restricted with food choices and train her/him for the same. Here are nutritional recommendations by experts for managing type 1 diabetes in children
Type one Diabetes Mellitus is an autoimmune condition characterized by insulin deficiency and hyperglycemia in people with underlying genetic susceptibility. The diagnosis is established based on the tests, fasting blood glucose (FBS), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c) or random plasma glucose (along with characteristic signs and symptoms of hyperglycemia), using standards recommended by American Diabetes Association.
As per the ICMR (Indian Council Of Medical Research), there are certain guidelines laid down for the management of nutrition in Type I DM as nutrition and lifestyle management play a vital role. The diagnosis of yype 1 diabetes in a child can be harsh to take as the child becomes dependent on the external supply of insulin through injections or insulin pipes as the body no longer produces insulin, an essential hormone.
The parents need to learn to manage the food intake of the child while keeping the condition in mind without making the child feel restricted with food choices and train the child for the same. In an interview with HT Lifestyle, Moumita Routh, Dietician at Apollo Cradle and Children’s Hospital in Bangalore's Koramangala, advised, “One of the important choices that need to be made is with regard to the diet of the child. The nutrients are essential for healthy growth. Carbohydrates are essential to the supply of energy. The monitored consumption of complex carbs like vegetables and whole grain is the best replacement for simple carb like those found in white bread that spikes up the sugar level.”
She cautioned, “Children should also be kept away from food that contains saturated fat, trans fat, and cholesterol along with high amounts of salt to keep children safe from heart risks and high blood pressure, both of which are the risk factors of Type 1 diabetes in children. Avoid sugary drinks and treats, however on special occasions balance the consumption throughout the day.”
Bringing her expertise to the same, Sharanya Shastry, Sports and Clinical Nutritionist, suggested a few recommendations for managing type 1 diabetes in children -
1- Complex carbohydrates to be included:
Generally, carbs are thrown out of the diet but in the case of pediatrics and adolescents, it is going to hamper their growth. Hence including complex carbs like millet (locally grown – Foxtail millet, jowar, adlay seed extract, whole wheat bread with hummus as a spreading) is beneficial but yes, you don't have to rule out carbs totally from the diet.
2- Including good quality protein
In children especially, protein of good quality and bioavailability is extremely important for growth and repair. They are made of amino acids and act as building blocks for the body and they also prevent sugar spikes. Including boiled eggs with breakfast (especially boiled egg whites daily), including lean cuts of meat (chicken breast – specifically in the form of a stew or a soup or boiled, fish – steamed or in the form of a fish cutlet) can show better results biochemically and psychologically. Meat fried, canned, or stored for a longer duration is generally avoided since they contain trans fat.
Other vegetarian sources are -
- Horse gram soup
- Oat–chia smoothie using low-fat milk with pea protein powder isolate (unflavored)
- Soya (fermented, called MISO) or
- Hand pound rice with vegetable dal – for any one meal or Multigrain bread stuffed with bell peppers, cucumbers, and hummus as a spreading
- Oats- green gram chila are some of the delicious options
3- Including good fats
For growing children, controlling their food choices are extremely challenging. Hence including omega 3 and omega 6 fatty acids in the form of sesame, walnuts, flaxseeds, and sunflower seeds in the forms of laddus, smoothies/shakes. Home-made ghee when consumed within the limit (1tsp/day) prevents spikes and keeps the person full. Therefore than consuming artificial butter/readymade cheese it is advisable to give your kids a tsp of homemade ghee to make the meal more nutritious and tastier. Anything fermented (homemade batter for idli/dosa), miso, and kombucha are better alternatives.
It is important to include an adequate amount of fiber in the diet but when it comes to kids, this might give rise to constipation or bloating, or acidity if there's not much physical activity. Hence including the right mix of insoluble and soluble fiber is essential. Example - whole wheat ajwain-peas parents with home-set curd and boiled channa/chole or kidney beans – corn-bell pepper-zucchini salad or a vegetable roll or an oat pancake with some tangy vegetable sauce are exciting options in a way through which you can push in fiber in the meal.
5 – Sweeteners
Sweeteners are much more sweeter than sugar and when not consumed in adequate quantity, they can cause hyperglycemia and it can get very addictive.
Therefore, reading the food labels and their nutritional value is very essential whenever you are buying any such ready-to-eat products. It is also quintessential to note that diets that motivate you to starve or deprive yourself of calories or put you on any salads or soups are not sustainable.