Healthy eating for type 1 diabetes

You will receive a meal plan from an RD in this format:

• Breakfast: _____ grams of carbohydrate
• Morning snack: _____ grams of carbohydrate
• Lunch: _____ grams of carbohydrate
• Afternoon snack: _____ grams of carbohydrate
• Dinner: _____ grams of carbohydrate
• Bedtime snack: _____ grams of carbohydrate

Estimated grams of carbohydrate: _____ per day or _____ per meal

Limit morning, afternoon, and bedtime snacks to _____ grams of carbohydrate.

Here are a few tools that can help with carbohydrate counting.

• Nutrition labels
• Measuring cups, measuring spoons, and digital food scales
• Restaurant nutrition information
• Smart phone apps

There may be times between scheduled meals and snacks that your child is hungry. There are foods that have little to no carbohydrate.

Free foods

• Are 5 or fewer grams of carbohydrate and fewer than 20 calories
• Must be limited to 3 each day and spread throughout the day

Free food ideas:

• 1 sugar-free Jell-O
• 1 sugar-free Popsicle
• 1 large dill pickle
• 1 cup light buttered popcorn
• 1/4 cup blueberries
• 1/2 ounce slice turkey with yellow mustard rolled-up
• 3 strawberries with 1 tablespoon plain Greek yogurt
• 3 sliced radishes with 1 tablespoon fat free cream cheese
• 1 cup non-starchy vegetable with 2 tablespoon Walden Farms dressing

If your child snacks on unlimited cheese sticks or slices of lunchmeat, it may affect his or her blood sugars.

Carbohydrates are the main fuel for the body and give you energy.

There are 2 kinds of carbohydrates:

1. Simple carbohydrates
   • Easy to digest
   • Raise blood sugar very fast
2. Complex carbohydrates
   • Have fiber and take longer to digest
   • Raise blood sugar slowly
   • Help keep your blood sugar in a healthy range

Fiber is found in plant foods:

• Whole grains
• Fruits
• Vegetables
• Legumes
• Nuts
• Seeds

There are 5 food groups with carbohydrates:

1. Starches
   • Grains
   • Starchy vegetables
   • Beans
   • Legumes
2. Fruit
3. Milk and yogurt
4. Non-starchy vegetables
5. Sweets and condiments

There are 2 food groups with no carbohydrates:

1. Protein
2. Fats

Note: These are not free foods just because they do not have carbohydrates to count.

Starches (15 grams of carbohydrate)

Choose whole grains and starches that are less processed. They are a main source of energy.

• 1/2 cup cooked unsweetened oatmeal
• 3/4 cup unsweetened cereal
• 1/4 cup granola
• 1 slice of bread
• 1/2 hamburger or hot dog bun
• 1/4 bagel
• 1/3 cup cooked pasta or rice
• 1/3 cup baked beans
• 1/2 cup refried beans
• 1/2 cup potatoes, corn or peas
• 4-inch cob of corn
• 3 ounces baked potato
• 2 ounces French fries
• 1/2 cup pasta sauce
• 3 cups popped popcorn
• 13 chips (1 small bag)
• 6 saltine crackers

Fruits (15 grams of carbohydrate)

Choose fresh or frozen fruits most often. They help with healthy growth.

• 15 small grapes
• 4-inch banana
• 4 ounce apple or pear
• 6 ounce orange
• 1 cup diced melon 1 cup berries
• 1/2 cup canned fruit (packed in light syrup or juice)
• 2 tablespoons raisins
• 1/2 cup fruit juice (fresh squeezed or store bought)

Milk and milk substitutes (12 grams of carbohydrate)

Milk and milk substitutes are important for bone health.

• 1 cup milk (non-fat, low fat, whole)
• 1 cup plain rice milk
• 1 and 1/2 cups plain almond milk
• 1 and 1/3 cups plain soy milk
• 2/3 cup plain yogurt
• 2/3 cup plain Greek yogurt

Non-starchy vegetables (5 grams of carbohydrate for 1 cup raw or 1/2 cup cooked)

Non-starchy vegetables have fiber to keep you full, and are low calorie and low carb.

• Artichoke
• Asparagus
• Baby corn
• Beets
• Broccoli
• Brussels sprouts
• Cabbage
• Carrots
• Cauliflower
• Celery
• Collard greens
• Cucumber
• Daikon
• Eggplant
• Gourds
• Green beans
• Green onion/scallions
• Jicama
• Kale (cooked)
• Kohlrabi
• Leeks
• Mushrooms
• Onions
• Pea pods
• Peppers (sweet and spicy)
• Radishes
• Spinach (cooked)
• Sugar snap peas
• Tomato
• Canned tomatoes (no sugar added)
• Water chestnuts

You do not have to measure or count leafy greens, such as:

• Romaine lettuce
• Iceberg lettuce
• Uncooked spinach
• Uncooked kale

Condiments (grams of carbohydrate varies)

Do not forget to count carbohydrates in dips, sauces, and dressings.

• 3 tablespoons barbecue sauce (15 g)
• 2 tablespoons chocolate syrup (15 g)
• 1 cup canned gravy (15 g)
• 2 tablespoons ketchup (10 g)
• 1 tablespoon pancake syrup (15 g)
• 2 tablespoons ranch dressing (4 g)

Sweets (grams of carbohydrate varies)

Sweets can fit into a healthy meal plan, but should be eaten in small portions. Limit sweets to special occasions or 2 to 3 times per week. It is best if the sweets can fit into a mealtime when insulin is given. Try not to eat sweets as one of your 10 gram or 15 gram carbohydrate snacks.

• 1 1/4-inch brownie, unfrosted (15 g)
• 2 ounce angel food cake, unfrosted (30 g)
• 2 ounce yellow cake, frosted (30 g)
• 1 3/4 ounce frosted cupcake (30 g)
• 4 ounce muffin (60 g)
• 1/2 cup (3 1/2 ounce) fruit cobbler (45 g)
• 1/6 of 8-inch fruit pie with two crusts (45 g)
• 1/8 of 8-inch pumpkin or custard pie (22 g)
• 1 1/2 ounce plain cake doughnut (22 g)
• 2 (1 ounce) doughnut holes (15 g)
• 3 3/4-inch (2 ounce) plain yeast doughnut (30 g)
• Two 2 1/4-inch chocolate chip cookies (15 g)
• One 6-inch (3 ounce) chocolate chip cookie (60 g)
• 2 sandwich cookies with crème filling (15 g)
• 5 vanilla wafers (15 g)
• 1/2 cup pudding, made with low fat milk (30 g)
• 1 ounce milk or dark chocolate candy (15 g)
• 5 chocolate Hershey Kisses (15 g)
• 3 pieces of hard candy (15 g)
• Popsicle (8 g)
• 1/2 cup vanilla ice cream (15 g)
• 1/3 cup frozen yogurt (15 g)

It is important to know which foods to limit or avoid to keep your blood sugar in a healthy range.

The usual blood sugar target ranges for children of all ages are:

• Before meals: 70 to 150
• 2 to 3 hours after meals: less than 180
• Bedtime and during the night: 90 to 150

Foods to limit

Sugar and processed carbohydrates make blood sugar rise and fall quickly.

Limit how much and how often you eat foods high in sugar and processed carbohydrate, such as:

• Chips
• Crackers
• Candy
• Cookies
• Ice cream
• Cakes/cupcakes
• Pies

Foods to avoid

Do not drink drinks sweetened with sugar, such as:

• Energy drinks
• Flavored milk
• Egg nog
• Fruit juice
• Regular soda
• Sports drinks
• Lemonade
• Sweet tea

You can drink these to treat a low blood sugar.

Do not eat breakfast foods with a lot of sugar and simple carbohydrate, such as:

• Breakfast pastries
• Doughnuts
• Flavored oatmeal
• Pop-Tarts
• Toaster pastries

Instead try:

• Fruit for a sweet treat
• Raw veggies and dip for a crunchy treat
• Drinks sweetened with artificial sweeteners, such as:
  • Crystal Light
  • MiO
  • Diet soda
  • Powerade Zero
• Breakfast cereal and flavored oatmeal with:
  • Less than 10 grams of sugar per cup
  • 3 or more grams of fiber per serving

Water and milk are always the healthiest choices.

Choose low fat proteins with less than 5 grams of fat per 1 ounce serving.

Protein foods are:

• Meat
• Poultry
• Fish
• Cheese
• Eggs
• Plant-based proteins, including:
  • Beans
  • Soy
  • Nuts
  • Seeds

Plant-based proteins have carbohydrates

Read the nutrition label on plant-based proteins. They are not carb free.

• 2 tablespoons nuts (3 g)
• 1 tablespoon peanut butter (3 g)
• 1 cup shelled edamame (15 g)
• 1/2 cup hummus (15 g)
• 1/2 cup refried beans (15 g)
• 1/3 cup baked beans (15 g)
• 1/2 cup lentils (15 g)
• 1/2 cup beans (15 g)
  • Includes black, garbanzo, kidney, lima, navy, pinto, and white beans

Proteins with breading

Read the nutrition label on proteins with breading. They are not carb free.

• Chicken nuggets
• Chicken fried steak
• Fried fish

Healthy cooking tips for proteins are:

• Trim fat off meat before cooking.
• Drain fat off meat after cooking.
• Grill and bake instead of deep or pan fry.
• Use non-stick cooking spray instead of butter.

You need fat for healthy growth. Some fats we should eat and drink more often and some less often.

Eat and drink monounsaturated and polyunsaturated (Omega-3 and Omega-6 fatty acids) fats each day:

• Avocado
• Almond milk
• Fatty fish, including:
  • Salmon
  • Tuna
  • Mackerel
  • Herring
  • Trout
  • Sardines
• Margarine
• Nuts
• Natural peanut butter
• Olives
• Olive oil
• Seeds

Limit the saturated fats you eat and drink:

• Butter
• Cream
• Whole milk
• Cream cheese
• Cheese
• Lard
• Fatty beef and pork
• Skin on chicken and turkey

Do not eat and drink trans fats.

There are 2 types of trans fats:

• Natural: dairy and meat products
• Artificial: processed foods

Processed foods are the main source of trans fats.

Look for trans fats in:

• Fried fast foods, such as:
  • Doughnuts
  • French fries
  • Fried chicken
  • Fried fish
• Baked goods, such as:
  • Cakes
  • Pie crusts
  • Biscuits
  • Cookies
• Frosting
• Frozen pizza
• Buttered popcorn, chips, and crackers
• Stick margarines, shortening, and other spreads

Look for the words “partially hydrogenated oils” in the ingredients list.

Foods may be labeled with 0 g trans fat if they have less than 0.5 mg per serving. Often you may eat more than one serving of the food and be eating several grams of trans fat.

Why limit saturated fats and avoid trans fats?

• They make bad (LDL) cholesterol go up and good (HDL) cholesterol go down.
• Eating too much makes your risk of heart disease and stroke goes up.

Foods and drinks that use artificial sweeteners give you more choices when eating or drinking something sweet.

The artificial sweeteners listed have been tested and approved by the U.S. Food and Drug Administration (FDA) as “generally regarded as safe” (GRAS). GRAS means experts have agreed that it is safe for use in moderation.

Many foods with artificial sweeteners may still have carbohydrate. Always check the label.

Non-nutritive sweeteners

Carbohydrate and calorie-free alternatives to sugar are:

• Acesulfame potassium (AKA-Acesulfame K)
• Aspartame
• Saccharin
• Stevia
• Sucralose
• Neotame

Be aware of products that may have additional carbohydrates or sugar alcohols. Always read the nutrition label and count any carbohydrate listed.

• Stevia in the Raw (dextrose)
• Truvia/PureVia (erythritol)
• Truvia baking blend (erythritol and sugar)
• Splenda sugar blend (sugar)
• Splenda brown sugar blend (sugar and molasses)

Sugar alcohols

Some sugar alcohols are:

• Erythritol
• Mannitol
• Sorbitol
• Xylitol

Sugar alcohols:

• Have fewer calories and less of an effect on blood sugar than sugar
• Are not completely carbohydrate free
• May cause gas, cramping, and diarrhea in some people

Salt is found in most processed foods to make them taste better and help them last longer. Most people eat too much salt. Too much makes your risk of high blood pressure, heart disease, and strokes go up.

Limit your salt intake by:

• Eating less processed foods
• Not eating out at restaurants
• Eating fresh or frozen vegetables over canned vegetables
• Looking for “low sodium” or “no added salt” on the label of canned foods
• Draining and rinsing canned beans and vegetables before heating or adding them to a recipe
• Buying spices without salt, such as garlic powder instead of garlic salt
• Getting rid of the salt shaker at home and season with herbs and spices
• Asking for your food to not be salted at restaurants

Foods high in salt are:

• Canned vegetables
• Canned soups
• Chips, crackers, and pretzels
• Breakfast cereals
• Bread and baked goods
• Lunchmeat, hotdogs, and other processed proteins
• Frozen pizza, breakfast sandwiches, and microwavable meals