Prediabetes in children is a growing concern, and a well-structured diet plan can play a crucial role in managing blood sugar levels and preventing the progression to type 2 diabetes. This article provides a comprehensive guide to creating an effective diet plan for children with prediabetes, incorporating expert recommendations and practical tips.
Understanding Prediabetes in Children
Prediabetes means that a child's blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. Pediatric type 2 diabetes is often associated with obesity and insulin resistance. It is very important to work on lifestyle changes with diet and exercise to promote weight loss. This condition increases the risk of developing type 2 diabetes, heart disease, and other health problems later in life. Lifestyle interventions, particularly dietary changes and increased physical activity, are essential for managing prediabetes and preventing its progression.
Key Principles of a Pre-Diabetic Diet Plan
The primary goal of a pre-diabetic diet plan is to stabilize blood sugar levels, promote healthy weight management, and ensure adequate nutrition for growth and development. Here are the key principles to keep in mind:
Balanced Meals: Focus on balanced meals that include a variety of food groups. A meal that contains a balance of carbs (including fiber), protein, and healthy fats can slow digestion, help you feel full, and provide a variety of important nutrients.
Carbohydrate Control:
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- Choose Healthy Carbs: Opt for complex carbohydrates that are high in fiber. People should consume healthier carbs like fruits, vegetables, whole grains and low-fat dairy foods.
- Limit Sugary Drinks: Avoid sweetened beverages such as sodas, sports drinks, juices, and gourmet coffee shop creations, which account for some of the biggest concentrated sources of added sugar. Instead, choose water. There are many sparkling waters available that have minimal carbohydrates or sugar substitutes. Also, try infusing your water with fresh fruits and herbs to help give flavor, but not add extra calories or sugar. Crystal Light, sugar-free lemonades or unsweetened teas are options, but should not be your primary hydration source.
- Carb Counting: Learning how to count carbs is a helpful skill to master. When you know how many carbs are in the foods your child eats, you can match their insulin doses much better.
- Portion Control: Help your child learn how much food is a healthy amount. This is called portion control.
Regular Meal Times: Eat at regular times and give your body two to three hours between meals to allow your blood glucose to lower to a desirable level before you eat your next meal. Don't let your child skip meals as this can cause them to overeat at the next meal. Even if your child is trying to lose weight, they should never skip a meal. They should only reduce portion sizes.
Increase Fiber Intake: Increase daily fiber to help overall blood sugar control as well as many other health benefits. Fiber slows the digestion and absorption of sugar and can help keep blood sugar levels in the healthy range.
Healthy Fats: Focus on adding healthy fats (like monounsaturated and polyunsaturated fats) to help lower your cholesterol and protect your heart. Healthy fats can be found in foods like olive oil, nuts, avocados, some types of fish, and a host of other tasty options.
Limit Processed Foods and Added Sugars: Less processed foods. The World Health Organization advises limiting added sugars to less than 10% of your total energy intake. For example, for someone on a 2,000-calorie daily diet, if they are following the 10% guideline, they would limit sugar calories to about 50 grams, which is about 12 teaspoons. That’s not a lot.
Hydration: Encourage water consumption throughout the day.
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The Diabetes Plate Method
Simplify healthy eating with the Diabetes Plate- a low-carb meal pattern jumpstart that helps you portion your plate and support your diabetes management.
- Start with a nine-inch plate.
- Fill half with non-starchy veggies.
- Fill one-quarter with lean proteins.
- Fill one-quarter with quality carbs like starchy vegetables, fruits, whole grains, or low-fat dairy.
Food Choices for a Pre-Diabetic Child
Vegetables
- Non-Starchy Vegetables: Fill half your plate with non-starchy vegetables for a healthy meal. These vegetables keep you feeling full for longer and provide you with the great-tasting nutrients your body needs without as many calories and carbs. Non-starchy vegetables include dark green and deep yellow vegetables, such as cucumber, spinach, broccoli, romaine lettuce, cabbage, chard, and bell peppers.
- Starchy Vegetables: Starchy vegetables include corn, green peas, lima beans, carrots, yams and taro. Note that potato should be considered a pure starch, like white bread or white rice, instead of a vegetable.
Choose fresh or frozen vegetables without added sauces, fats, or salt. Vegetables can prepared in many ways, including steamed, roasted, in a salad or dipped in dressing or hummus.
Fruits
While fruit does count as a carbohydrate food, they are loaded with vitamins, minerals, and fiber just like vegetables. Fruit can also help you satisfy your sweet tooth without the added sugar.
Choose fresh, frozen, canned (without added sugar or syrup), or unsweetened dried fruits. Try apples, bananas, berries, cherries, fruit cocktail, grapes, melon, oranges, peaches, pears, papaya, pineapple, and raisins. Drink juices that are 100% fruit with no added sweeteners or syrups. Fresh fruits can be paired with peanut/other nut butter.
Grains
There are 2 types of grains:
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- Whole Grains: Whole grains are unprocessed and have the entire grain kernel. Examples are whole-wheat flour, oatmeal, whole cornmeal, amaranth, barley, brown and wild rice, buckwheat, and quinoa.
- Refined Grains: Refined grains have been processed (milled) to remove the bran and germ. Examples are white flour, de-germed cornmeal, white bread, and white rice.
Grains have starch, a type of carbohydrate. Carbohydrates raise your blood sugar level. For healthy eating, make sure half of the grains you eat each day are whole grains. Whole grains have lots of fiber. Fiber in the diet keeps your blood sugar level from rising too fast. Examples of healthy carbohydrates are whole wheat pasta, brown rice, whole wheat bread, and oatmeal. Whole wheat crackers with low-fat cheese are also a good option. High fiber cereal is a good choice.
Protein Foods
Protein foods include meat, poultry, seafood, eggs, beans and peas, nuts, seeds, and processed soy foods. Eat fish and poultry more often. Remove the skin from chicken and turkey. Select lean cuts of beef, veal, pork, or wild game. Trim all visible fat from meat. Bake, roast, broil, grill, or boil instead of frying. When frying proteins, use healthy oils such as olive oil. Examples are lean meats including poultry and fish. Eggs can be prepared any way your child prefers.
Dairy
Choose low-fat dairy products. Be aware that milk, yogurt, and other dairy foods have natural sugar, even when they do not contain added sugar. Take this into account when planning meals to stay in your blood sugar target range. Some non-fat dairy products have a lot of added sugar. Be sure to read the label. Examples are dairy products such as cheese or Greek yogurt.
Oils/Fats
Oils are not considered a food group. But they have nutrients that help your body stay healthy. Oils are different from fats in that oils remain liquid at room temperature. Fats remain solid at room temperature.
Limit your intake of fatty foods, especially those high in saturated fat, such as hamburgers, deep-fried foods, bacon, and butter. Instead, choose foods that are high in polyunsaturated or monounsaturated fats. These include fish, nuts, and vegetable oils.
Oils can raise your blood sugar, but not as fast as starch. Oils are also high in calories. Try to use no more than the recommended daily limit of 7 tsp (35 ml).
Sample Meal Plan
Here is a sample meal plan for a pre-diabetic child. This should be adjusted based on the child's age, weight, activity level, and individual needs.
- Breakfast: Oatmeal with berries and nuts, a side of low-fat Greek yogurt.
- Snack: Apple slices with peanut butter.
- Lunch: Whole wheat sandwich with lean turkey, lettuce, and tomato; a side of carrot sticks.
- Snack: A small handful of almonds and a piece of fruit.
- Dinner: Baked chicken breast, steamed broccoli, and brown rice.
Healthy Snacking
Healthy snacks can be part of your meal plan and help with hunger management between meals. Before you reach for a snack, figure out if you are hungry or thirsty (sometimes being thirsty can make your body think it’s hungry). If thirsty, drink water or a zero-calorie beverage. This can help prevent adding more calories to your day. When you do select a snack, choose healthy options that offer a combination of protein, healthy fats, and fiber, with or without carbohydrates.
Low-Carb Snack Examples
- Vegetable, miso, chicken, or beef broth.
Addressing Common Misconceptions
- Sugar-Free Doesn't Mean Carb-Free: Many people mistakenly think that sugar-free foods don't contain carbohydrates. However, these foods are often still high in carbohydrates, even if they aren't sugars. They may also contain sugar alcohols, which still raise blood sugar.
- Fat-Free Can Be High in Sugar: Fat-free foods can also be higher in carbohydrates. To make up for the lack of fat, many of these foods use a high amount of sugar to create flavor. If you aren't sure what is in your child's food, always check the nutrition label for the number of carbohydrates.
The Importance of Physical Activity
Physical activity can help prevent diabetes while boosting heart health. Regular physical activity is crucial for managing prediabetes. It helps improve insulin sensitivity, lower blood sugar levels, and promote weight loss. Seymour recommends that people with prediabetes try to get at least 150 minutes per week of moderate to vigorous exercise or aim for 10,000 daily steps. Activity lets your muscles use sugar from the blood without needing insulin to move the sugar into the muscle cells.
Monitoring and Adjustments
Regular monitoring of blood sugar levels is essential to assess the effectiveness of the diet plan. Keep a food log. If you want a dietitian to review what your child is eating, jot down what your child eats and when, the number of carbs, and blood sugar readings before eating. The log will help the care team decide if they need to adjust your child’s care plan.
Working with a Healthcare Team
Because everyone is different and many people with prediabetes have other health issues, Seymour says it is important to tailor prediabetes food plans to the individual. Work with a registered dietitian to design a meal plan for your child. A registered dietitian is an expert in food and nutrition. People diagnosed with prediabetes can ask their primary care practitioner for a referral to a local registered dietitian.
Long-Term Strategies
To steer away from type 2 diabetes, Seymour says men and women should try to achieve and maintain a body mass index of 25 or lower. Even small amounts of weight loss can have a benefit. The ADA states that moderate rate reduction of 5% to 10% of your body weight can significantly lower your A1C level.