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March 10, 2009

Meal Planning, Food and Diet

Question from Ireland:

With regard to food choices for a child with type 1, I have a few concerns. I try to eat as healthily as possible and try to get my daughter to follow a similar diet. Try as I might, she will not really eat vegetables and I am concerned about the amount of nutrients she consumes. I know that five portions of fruit and vegetables are the minimum recommended intake. To make up for the lack of vegetables, I give her a lot of fruit, but this has a bad effect on her blood sugars. She loves bananas and pears especially, but will eat almost any fruit. I feel terrible refusing her fruit when she asks for it, especially because, before diabetes, she had free run of the fruit bowl. She is only six and assumes that because I always told her that fruit is good for her, she should be allowed it at any time. Can you recommend which types of fruit I can give her that will not cause such a big rise in blood sugars? I do give her fruit with her three meals and allow insulin for it, but she always wants it as a snack between meals and this inevitability causes a consequent high blood sugar. She is on Lantus at night and NovoRapid with meals. It seems ridiculous to battle her daily over fruit. Can you recommend an alternative?

Answer:

You’re doing a good thing by working fruits into your daughter’s meal plan. What I would recommend is limiting the portion sizes that you give her at any meal or snack and make sure to combine a healthy source of protein and or fat with the fruit. Try adding some peanut butter with a banana to try adding some low fat cheese with grapes or strawberries. This combination of carbohydrate and protein will tend to slow down the rise in post meal blood sugars and might fill her up a little easier so that she will not overconsume the carbohydrates in fruit.

Keep up the good work with meal planning and working both fresh fruits and vegetables into your daughter’s meal planning.

JMS

[Editor’s comment: You might also want to discuss with your diabetes team whether or not you should give your daughter NovoRapid when she consumes fruit for her snack.

BH]