What is a meal plan?

A dietitian will help you make a meal plan. A meal plan helps you decide what kinds of foods your child can eat for meals and snacks. It also tells you how much food (how many servings) your child can eat and when to eat. A good meal plan will consider your goals, tastes, and lifestyle, as well as any medicines your child is taking. Following the meal plan is important. It helps manage your child’s blood sugar. Try to stick to the same schedule for meals and snacks. That's how you can best control your child’s blood sugar level. Of course, this won't always be possible. So, the meal plan should be flexible. You should be able to make adjustments. The meal plan will also need to be changed as your child grows.

A good meal plan includes:

• More nonstarchy vegetables, such as broccoli, spinach, and green beans.

• Fewer added sugars and refined grains, such as white bread, rice, and pasta with less than 2 grams of fiber per serving.

• As many whole foods as possible instead of highly processed foods.

• Eating carbs along with foods that have protein, fat, or fiber, which will help slow down how quickly your blood sugar rises.

Understanding carbohydrates   

Different foods affect blood sugar in different ways. Foods high in carbohydrates (carbs) raise blood sugar quicker than other foods. This is why you must keep track of the carbs that your child eats. Carbs are in fruit. They're also in starchy foods. These include potatoes, corn, and beans. Carbs are in a lot of foods. So they can be hard to keep track of. You may even be tempted to cut them out of your child’s diet. But carbs play a key role in your child’s health. They are the body’s main source of energy.

Your child’s care team may teach you about carb counting. This is a precise way of counting how many carbs your child is eating each day. One serving of a starch, fruit, or dairy product counts as 1 carb. Each carb choice is about 15 grams of carbs. Eating a consistent amount of carbohydrates at each meal can help to regulate blood sugar levels, especially if you take about the same amount of insulin at the same time every day (fixed regimen). The team will also teach you about portion sizes, food groups, and how each food affects blood sugar.

Carb-counting tips

You, your child, and their teachers will need to keep track of the amount of carbs eaten for each meal and snack. This information is important. It helps you, your child, or their teachers balance the amount of carbs eaten with the correct amount of insulin. Here are some ways to help your child and others manage your child’s blood sugar:  

• Let your child help measure food. This helps them learn about portion sizes.

• Write down the amount of carbs of each food on the wrapper of each food. Or write it on a napkin or separate piece of paper. Then stick it into the lunchbox or bag. If your child uses a smartphone, see if there are apps that may be used to track carbs.

• Include snack times on a napkin or piece of paper. Put this into the lunchbox or bag.

• Write down the amount of carbs of each meal on your child’s school lunch menu.

Reading food labels

Always read food labels. The information on them will help you choose healthy foods. That will make managing your child’s blood sugar easier. Look for the Nutrition Facts label on packaged foods. This label tells you how many carbs and how much sugar, fat, and fiber are in each serving. Then you can decide if the food fits your child’s meal plan.

1. Servings. Read this closely because the package, jar, or can may contain more than 1 serving. This is how to measure 1 serving of the food in the package. If you eat more than 1 serving, you get more of everything on the label—including fat, cholesterol, and calories.

2. Total fat.  This tells you how many grams (g) of fat are in 1 serving. Fat is high in calories.

3. Saturated fat.  This tells you how much saturated fat is in 1 serving. Saturated fat raises your cholesterol the most. Look for foods that have little or no saturated fat.

4. Trans fat.  This tells you how much trans fat is in 1 serving. Even a small amount of trans fat can harm your health. Choose foods that have no trans fat.

5. Cholesterol. This tells you how much cholesterol is in 1 serving. For many years, it was advised to eat less than 300 milligrams (mg) of cholesterol a day. New guidelines have removed this limit. That's because cholesterol has been shown to not raise blood cholesterol levels as much as it was thought to in the past. But many foods high in cholesterol are also high in saturated fat. So it's advised to limit saturated fat in your diet.

6. % Daily value.  The higher the number, the more 1 serving has of that nutrient. Look for foods that have low numbers for total fat, saturated fat, cholesterol, and sodium. Foods that are higher in fiber, vitamins, and minerals (iron and calcium) are good choices. 

7. Sodium. This tells you how much salt is in 1 serving. Choose foods with low numbers for sodium.

8. Dietary fiber.  This number tells you how much fiber is in 1 serving. Foods that are high in fiber can help you feel full. They can also be good for your heart and digestion. The recommended daily amount of fiber is 25 grams for women and 38 grams for men. After age 50, your daily fiber needs drop to 21 grams for women and 30 grams for men.

Learning portion sizes

Portion control is an important part of healthy eating. Portion size and serving size aren’t always the same. A portion is the amount of food you choose to eat at one time, while a serving is a specific amount of food, such as one slice of bread or 8 ounces (1 cup) of milk. How much food your child eats affects their blood sugar.

Your child’s care team can show you how to measure the right amount of food for meals and snacks. Until you learn what portion sizes look like, use measuring cups and spoons. This helps you to be sure portions are accurate. In an age-appropriate way, teach your child how to measure portion sizes and why it's important. This will help them develop the skills needed to manage diabetes as they grow up.

Exchange planning. With exchange planning, all foods are grouped as either a carbohydrate, meat or meat substitute, or fat. In the exchange system, one serving of a carbohydrate (such as one small apple) can be exchanged for any other carbohydrate (such as 1/3 cup cooked pasta), because both servings contain about 15 grams of carbohydrate. You can easily know the carbohydrate content of your meals and snacks by using the exchange system.

Food for thought

These tips can make things easier on you and your child:

• Try not to be the food police. You want your child to eat healthy foods. But try not to put too much pressure on them. This will only make your child more likely to want to stray from the meal plan.

• Stock up on healthy snacks. If your child is active, they may need a snack before, during, and after the activity. Bring snacks to sports events and activities. Snacks help maintain your child’s blood sugar during exercise. Give your child a few healthy snack choices so they can feel a sense of control. Most often, your snacks should be easy-to-digest foods that have 15 to 45 grams of carbohydrates.

• Be positive. Acknowledge and support your child's efforts. Teach them about diabetes and healthy eating. Give them age-appropriate control over healthy food choices.

To learn more

For more information about diabetes, visit these websites:

• American Diabetes Association at www.diabetes.org

• Juvenile Diabetes Research Foundation at www.jdrf.org

This sheet doesn't give all the information you need to care for your child who has diabetes. Ask your child’s care team for more information. Keep a record of your child’s carb intake, insulin doses, and blood sugar readings before visiting their health care provider.