What Should I Eat?

Healthy eating is important for all kids, including kids with diabetes. Your body needs the right balance of healthy foods to grow and develop, and to help you look after your diabetes. Understanding all about the food you eat can help you to make healthy choices.

Healthy Eating is easy! 
Healthy eating is as easy as choosing foods from the “eat most” section of the healthy food pyramid everyday, with smaller amounts of “eat moderately” foods each day. The “eat only a little” foods should only be included in small amounts or enjoyed for treats.

 
To be healthy you need to eat a variety of food every day
This food pyramid is a good guide to making good choices

Kids with diabetes don’t need special foods, so your friends, brothers and sisters should all be eating the same healthy foods as you, everyday!

All About…Carbohydrates, Proteins & Fats 
Carbohydrates, proteins and fats are found in the food you eat. They give your body energy and help you to grow. Everyone needs the right amounts of carbohydrates, proteins and fats each day for good health.

Carbohydrates 
Carbohydrate foods give your body the energy to do all the things you like doing. When you eat carbohydrate foods, they break down into sugar or glucose in your body. With the help of insulin, your body uses this glucose for energy.

Carbohydrate foods are things like:
• Bread and bread rolls
• Breakfast cereals
• Dairy and soy milk, yoghurt, ice cream and custard 
• Fruit and fruit juice
• Starchy vegetables like potato, sweet potato and corn
• Rice, pasta and noodles
• Baked beans and lentils
• Snack foods like biscuits, chips, muesli bars
• Sugars and sugary foods 
• Takeaway foods like pizza, chips and burgers

• To look after blood glucose levels (BGLs) it’s important to eat carbohydrate foods at each meal and snack and try to balance these from day to day.
• Carbohydrate exchanges can help – exchanges (or serves) tell you how much carbohydrate is in different foods. Counting carbohydrate exchanges can help you balance the carbohydrate foods that you eat with your activity level and insulin dose. 
• The type of carbohydrate foods that you eat is also important. The best carbohydrates to choose every day are things like fruit, bread, cereals, low fat milk & yoghurt, starchy vegetables, rice and pasta. 
• Sugars and sugary foods are not the best carbohydrates to choose because they put a lot of glucose in to the blood stream and may cause high BGLs. 
• Some carbohydrate foods give you longer lasting energy. These foods are things like grainy breads, raisin bread, fruit, baked beans, pasta, noodles, yoghurt and milk. These carbohydrates are good when you need longer lasting energy, like before sport. They are also a great choice before bed.

Proteins
Protein foods are important to help you grow and develop. Protein foods are things like:
• Meat
• Fish
• Chicken 
• Eggs
• Cheese

Kids need about 1-2 serves of protein foods each day for good health. One serve is how much fits into the palm of your hand. Most protein foods don’t breakdown into glucose in your body, so they don’t raise BGLs. Unlike carbohydrate foods, you don’t need to count protein foods or eat these at each meal and snack. The best protein foods to choose are the ones that are the lowest in fat – like fish, lean meat, chicken without skin, eggs and low fat cheese.

Fats
Fats are important for good health, but you only need a small amount everyday. Fats are found in lots of different foods, especially:
• Butter
• Margarine 
• Oil
• Cream

Some fats are better for you than others. The best types to choose are the vegetable fats like margarine and vegetable oils. Fats don’t raise BGLs, but too much fat can lead to health problems like being overweight or having high cholesterol (a type of fat in the blood). Remember that fat can also be added to foods, especially things like snack foods and takeaways. Try not to eat too much fat or foods high in fat.

Food & Diabetes 
It is important for everyone to make healthy food choices. When you have diabetes there are some extra things that you also need to think about to help look after diabetes and keep you healthy. It is important to:

Eat your meals and snacks at the right time 
Depending on the insulin you are on, you might need to eat every 3 hours or so. If you forget to eat, skip meals or leave it too long until you eat, you might have a hypo (low BGL).

Eat carbohydrate foods at each meal and snack
You need to make sure that you eat some carbohydrate foods at breakfast, lunch and dinner and at snacks like recess, afternoon tea and supper. If you have been told to follow carbohydrate exchanges, try and eat around the same number of exchanges at meals and snacks each day.

Choose foods low in fat
Too much fat can be bad for your health. Try to choose low fat milk, yoghurt, and cheese. Watch out for foods that are high in added fats, like snack foods - crisps, biscuits, chocolates, cakes, donuts, as well as takeaways, fatty meats and fried foods.

Watch out for foods that are high in sugar
Foods high in sugar like regular soft drinks, cordials and lollies can cause BGLs to go too high. Make sure that you use diet / low joule soft drinks and cordials and try to save lollies for special occasions. Foods high in sugar can be used to treat a hypo.

Always carry hypo foods
Sometimes BGLs can drop too low and you can have a hypo. To treat a hypo, you need to quickly eat or drink something sweet and then eat something else straight away to stop the hypo from coming back. Make sure that you always have hypo foods like juice or jellybeans with you, plus follow up carbohydrate foods like plain biscuits or a muesli bar to stop you from dropping low again.

Healthy Eating Day 2 Day
To be healthy, it’s important to make healthy food choices from day to day. This means having a healthy lunchbox, having healthy snacks and being a detective in the supermarket and looking for healthy food choices.

Food at School

A healthy lunchbox…
It is important that you eat the right amounts of food at recess and lunch to help keep your BGLs mostly within the normal range. If you are not sure, mum, dad or someone at home can help by writing you a list for your lunchbox and labelling what to eat when. Stickers are a fun way to label your food! It is important not to skip recess or lunch or you might have a hypo.

Try some of these healthy lunchbox ideas:
• Sandwiches 
– try different types of breads like rolls, grain bread, Turkish bread, bagels, lavash or pita bread
– fill with your fave fillings like salad, low fat cheese, vegemite, ham, chicken, tuna, salmon, egg, baked beans, spaghetti or banana
• Pasta, potato or rice salad
• Fresh pieces of fruit eg. apples, pears, mandarins, oranges
• Chopped fruit eg. rockmelon, pineapple
• Fruit in zip lock bags eg. grapes, cherries
• Fruit snack packs (plus a spoon)
• Crispbreads, rice cakes or corn thins
• Pikelets, scones or low fat muffins
• Low fat yoghurt or dairy desserts
• Dried fruit boxes eg. sultanas, apricots
• Small tins of baked beans or spaghetti
• Low fat milk tetra pack
• Rice crackers or rice crisps

To keep lunch cool, add a frozen water bottle to your lunchbox or use a cool pack!

Lunchbox swaps…
If you want to do a lunchbox swap, make sure you are swapping something the same, like a sandwich for a sandwich. Otherwise you might not get enough carbohydrate and might have a hypo later. Try not to swap your lunch too often.

At the canteen…
Canteen foods are OK, but not a good choice everyday – once a week is plenty. Talk to mum, dad or someone at home about the best types of foods to choose from the canteen.

Special events at school…
Parties, birthdays and special events at school can be lots of fun. You can join in the fun like all of your friends and enjoy some special treat foods. Remember to tell mum, dad or someone at home when there's a party at school, this can help them work out if they need to make any changes to your insulin. They can also help you decide how to swap some party foods for your usual recess or lunch.

Snack Attack 
Snacks like recess, afternoon tea and supper are important to help keep BGLs mostly in the normal range. Kids love snacks and there are heaps of healthy snacks that you can try, like:

• Piece of fresh fruit e.g. apple, pear, banana, orange
• Chopped fruit – rockmelon, pineapple, honeydew
• Fresh fruit salad
• Frozen pieces of fruit
• Grapes or cherries
• Canned fruit snack pack e.g. two fruits, peaches, pears, fruit salad
• Dried fruit boxes e.g. sultanas, fruit salad, sultanas and apricots
• Low fat yoghurt
• Low fat dairy desserts
• Low fat custard
• Corn cob
• Pikelets with fruit jam
• Fruit loaf or fruit bun 
• Plain or fruit scones
• Crispbread or rice cakes with low fat toppings e.g. tomato, low fat cheese
• Popcorn
• Crumpets or English muffins
• Rice crackers with low fat dip
• Rice crisps
• Low fat fruit bars

Being a Supermarket Detective
Looking at food labels when you are in the supermarket can help you find the best everyday food choices. To work out the best choices, look at the nutrition panel on the food label. This tells you things like how much carbohydrate and fat is in different products. A nutrition panel looks like this:

Servings per pack: 1 Serve Size 200 g
	Per 200g serve	Per 100g
Energy Protein Fat Saturated fat Carbohydrate -total -sugar Sodium	864kJ 8.2g 5.0g 2.0g 31.8g 27.8g 298mg	432kJ 4.1g 2.5g 1.0g 15.9g 13.9g 149mg
Ingredients: Full cream milk, concentrated skim milk, skim milk, sugar, thickener, vegetable gums, mineral salts, flavour

To make healthy food choices, compare different products and look for foods that are lowest in fat, especially saturated fat. To work out carbohydrate exchanges, look at how much total carbohydrate is in the food in the amount that you are going to eat.

One exchange is the amount of food that contains 15 grams of total carbohydrate. Look at the amount of total carbohydrate in the per serve column, then divide by 15. For example, the food shown above is equal to about two exchanges because it has around 30 grams of total carbohydrate divided by 15 = 2 exchanges.

You can also look at the ingredient list to work out whether or not the food is a healthy choice. If fat (e.g. butter, cream, oil) or sugar (e.g. sugar, sucrose, glucose) are listed first or second then the product may not be a good everyday choice.

It’s party time!
Everyone loves parties, and kids with diabetes can join in and have as much fun as everyone else and enjoy some special treat foods. Mum, dad or someone at home will help you work out how to balance your food, activity and insulin dose when you go to a party.

Kids with diabetes can enjoy party fun as much as everyone else, but don’t forget to:
• Eat regular carbohydrate foods while you’re at the party 
• Take some hypo foods with you and make sure that an adult at the party knows what to do if you have a hypo
• Take some diet soft drink with you or maybe everyone at the party can have diet soft drink?
• Have a good supper that night – you might need extra carbohydrates at supper, especially if you have been running around a lot
• Have fun!!

Try some of these tasty party treats:
• Mini pizzas – with chicken, ham or vegies on top
• Pikelets – plain, banana or sultana
• Chunky chips or potato wedges
• Crumbed chicken strips
• Fish fingers 
• Chicken skewers
• Muffins – try berry, banana or choc chip
• Frozen fruit blocks
• Yummy yoghurt cups
• Fruit kebabs
• Ice cream in a cone
• A Paddlepop or Billabong
• Popcorn 
• Party pretzels
• Crackers and dip
• Chocolate mousse cups 
• Diet jelly cups
• Sushi

Food 4 Sport
When you are active you need extra carbohydrate foods for energy and to stop your BGL from dropping too low. You might need extra carbohydrate foods before the activity, then every 30-40 minutes, especially if you are really active. Sometimes you might also need extra carbohydrates at dinner or before bed, to stop you from having a hypo later on.

Try these great carbohydrates before sport:
• A piece of fruit
• A small flavoured milk 
• A muesli bar
• A fruit snack pack
• A crumpet or slice of raisin toast
• A ‘fun size’ chocolate bar

To top up during sport, try:
• A 100% fruit juice popper 
• A cup of sports drink
• A piece of fruit eg. banana, orange

Don’t forget to pack a hypo kit with hypo foods for sport.

Takeaways
Lots of takeaway foods can be high in fat and sugar. To be healthy, it is a good idea not to eat takeaways any more than once a week. When you choose takeaways, it is important to try and make the healthiest choices, look for lower fat takeaways like:
• Lean meat or chicken salad roll / wrap
• Doner kebab with lots of salad
• Plain hamburger with lots of salad
• A grilled chicken burger with lots of salad
• Baked potato (skip the butter)
• Toasted sandwich
• Corn cob 
• Sushi roll
• Vegie pizza or gourmet pizza 
• Toasted sandwich or focaccia
• Small bowl of pasta with tomato based sauce 
• Stir fried vegetables & noodles or plain rice

Take care with choosing drinks - avoid regular soft drinks as these are very high in sugar, choose diet or low joule drinks instead. If you are having juice, look for 100% fruit juice and choose a popper or small bottle.

Lots of takeaways are also very high in carbohydrate (eg. pizza, fries, smoothies). If you can, check out to see if the takeaway outlet has any nutrition information available. Many of the popular fast food chains eg. McDonalds, Subway, Krispy Kreme have nutrition information brochures that tell you the amount of fat and carbohydrate in their different products. Look for foods that are lower in fat and have about the same amount of carbohydrate to what you would normally eat at your meals. If you and your family adjust your insulin depending on what you eat, use this information to make sure that you take the right amount of insulin when you eat takeaways.

Healthy eating on an Insulin Pump…
Insulin pumps can be a great way to help manage your diabetes. If you decide to start on a pump you might notice that a few things about food are a little bit different…like closer counting of your carbohydrate exchanges / amounts, and more flexible meal times and amounts of food.

Why do you need to count carbohydrates?
We know that carbohydrate foods put glucose (sugar) into your blood stream for energy. The insulin you inject needs to match your carbohydrate foods (and activity) to keep BGLs mostly in the normal range. This is important whether you are on a pump or not.

When you are on a pump you can match your food and insulin more closely because every time you eat, you program the pump to give you quick acting insulin. Your diabetes team will tell you how much insulin you need to give for every carbohydrate exchange you eat. Some pumps even let you program in how many grams of carbohydrate you have eaten and it then works out how much insulin to give.

How do you work out how much carbohydrate is in different foods?
Your dietitian can help you work out how much carbohydrate is in different foods. You might need to weigh or measure some foods to help you count carbohydrates. You and your parents also need to be able read food labels to work out how much carbohydrate is in different foods.

Do you need to follow set carbohydrate exchanges?
When you are on an insulin pump you don’t need to eat the same number of exchanges at your meals each day. If you are not very hungry you can eat less and if you are really hungry, you can eat more. You can then give your insulin depending on how much carbohydrate you have eaten.

Do you need to eat snacks between meals?
On an insulin pump you don’t need to have snacks if you don’t want to, but it is important to eat three main meals a day to be healthy. Some kids still might need to have snacks to get the energy they need for all fun things they like to do.

Does being on a pump mean you eat anything you want?
When you are on a pump, you still need to make healthy food choices. Lollies, soft drinks, crisps and chocolates are not an everyday food for anyone. On a pump, you should still use diet or low joule soft drinks and keep snack foods as special occasion treats.

What do you do at school when you are on a pump?
At school, you need to remember to give your insulin bolus when you eat. To do this, you need to know how much carbohydrate is in the foods that you have at recess and lunch – asking mum, dad or someone at home to label the food in your lunchbox can help. Knowing the amount of carbohydrate in different canteen choices is also important.

What about food for sport when you are on a pump?
When you are on an insulin pump you can still play sport. You might find that you still need some extra carbohydrate foods for energy. On a pump you can reduce your insulin before and after sport and you might not need to eat as much extra food to prevent hypos. When you start on a pump your Dietitian can give you some extra healthy eating info.

Source: http://www.diabeteskidsandteens.com.au/foodnews.html