Food: It's What's for Eating

An 8 year old relative of a friend of mine was recently diagnosed with type 1 diabetes.  A couple of weeks post-diagnosis, my friend e-mailed saying that the family is really struggling with what to feed him.  He was previously very much a junk-food fan.  What ideas and advice did I have?

My initial e-mail response was lengthy and probably a little confusing.  It's such a complicated and loaded question.

My first response was to look for good articles and posts on my favorite blogs and websites.  After twenty minutes of that, I found twenty different ideas of how best to eat with diabetes.  No wonder they and so many other newly-diagnosed families are confused. 

I imagine the hospital team sent them home with a meal planning guide and some hand-outs about carbohydrate counting and the value of consuming protein and carbs together.  He's on injections for now, so limiting the injections is part of meal planning too.  But he's 8.  And everything's different.  And he'd probably really like a big stack of pringles and a snickers bar.

So here's what I said in a nutshell, hopefully more well-thought out this time (I'll be sure to get them the link to this post):

1. If nothing else, count the carbs.  Learn how to read the labels, learn the carb ratio, learn the math and give the insulin.  A snickers bar is not an apple.  French fries aren't steamed brown rice.  But if you give the right amount of insulin for them, his blood sugar won't spike astronomically and you'll be learning and practicing the carb counting skills which will be the basis of diabetes care for the foreseeable future.

2. Rome wasn't built in a day.  Protein plus carbs is great.  The combination streamlines the blood sugar levels.  Vegetables, fruits, whole grains and low-fat proteins are important too.  Foods with fiber affect the blood sugar less than straight white bread.  BUT eating is great too, and sometimes compromise is necessary.  I had a child who ate nothing but cold cereal, milk, chicken nuggets, goldfish crackers, baby carrots, sugar free jello jigglers and animal crackers for several months of her toddlerhood.  She lived to tell the tale.  Not only that, but this weekend she ate Moroccan spiced chicken stew with whole wheat couscous on Saturday night and roast salmon, salad with balsamic dressing and a brown rice medley on Sunday night.  We actively chose (after a few weeks of frustration) not to force the food issue when she was 2.  Now she's a good healthy eater, because that's the way her parents eat and she slowly learned that a variety of foods are delicious. 

3. Dessert is okay.  We never stopped having treats.  One cookie instead of 3?  Yes.  Parsing out the Halloween candy over a couple of weeks.  Absolutely.  She had animal crackers and a glass of milk most nights until she was 5 or so.  Eventually, other cookies, frozen treats and brownies began to be included in the mix.  Holiday pies and birthday cakes have never been forbidden.  As a result, (I think) I have a kid who has rarely snuck extra treats or cried because she was left out of a celebration. 

Should this newly diagnosed kid be eating a scrambled egg wrap for breakfast, bean soup for lunch and a plate with 2 veggies, lean protein and whole grains for dinner?  Probably.  Should his primary treat be roasted almonds?  Yup.  But he's 8.  And his world just turned upside down.  And no kid or adult really eats like that anyway (well- very few, and they're probably not the happiest people). 

In the real world, balance is necessary. This newly diagnosed kid should be eating the healthiest combination of foods he's willing to eat on a daily basis.  He should be learning about good nutrition from his family, his healthcare team, and others who care about him.  He should be learning to read a nutrition label with help from adults, so that he can take the right amount of insulin for whatever he eats.  He should be learning about low carb and carb-free snacks he can eat when he's hungry but doesn't want to take an injection.  Meanwhile, his favorite foods should remain available and he and his family should learn how to cover the carbs in them. And he should have the occasional junk food if he wants it.  Having diabetes is hard enough as it is.