One week’s worth of tasty back-to-school lunches from a type 1 mom who is also a certified diabetes educator.
Written by Marina Chaparro, RD, CDE, MPH
The new school year has begun and this brings along the added challenge of packing the dreaded school lunch—an especially daunting task for some parents. Everyone wants their child to have a healthy diet but healthy foods aren't always the ones kids reach for first. I mean have you ever heard a child ask for more Brussels sprouts? When your child has type 1 diabetes, blood sugar management also has to be part of the thinking here.
The trick is to find foods that they'll actually eat and I'm here to tell you that they ARE out there! to making this come together is to find healthy food that they'll actaully eat!
Children spend up to two-thirds of their time in school and school-related activities, so it’s important they receive the appropriate fuel and medications needed to keep blood sugars within the target. Schools play an essential role in managing a child’s diabetes. Diabetes does not take a vacation or stop at school. Younger or newly diagnosed kids with diabetes depend on school staff to monitor blood sugars, recognize high and low blood sugar symptoms and administer insulin.
Public Schools and charter schools who receive federal funding are required to have a diabetes medical management plan or a 504 plan. The 504 plan refers to the section of the Rehabilitation Act of 1973, which is a is a federal civil rights law that prohibits discrimination on the basis of disability. It makes sure schools provide appropriate and reasonable accommodations to allow children with diabetes to be safe and receive a proper education.
The diabetes medical management plan is an individualized form that includes doctor’s orders and gives specific instruction on when to check blood sugars, symptoms of low and high blood sugar and how much insulin to provide for certain foods. Sylvia White, RD, CDE and parent of two children with type 1 diabetes explains. “I had a care plan from the doctor specifying what the school needed to do with my child to provide the proper care. I met with the teachers and informed them that my children might need to go to the office for low or high blood sugars and what symptoms to watch for," White says.
Children with diabetes might need special accommodations when it comes to school and medications, but they don’t necessarily require a special diet. Surprising as it may be, children with diabete—like all children—need a variety of foods, including whole grains, vegetables, fruits.
Although kids with diabetes can eat the same foods as other kids, particular attention may need to be given to carbohydrates. "There is no such thing as a diabetic diet—all children need healthy lunches instead of junk food,” explains White who is the founder of ParentingDiabetes, an education site for parents of children with type 1 diabetes.
With the alarming rates of type 2 diabetes and obesity in youth, it becomes even more important to limit junk food and provide opportunities for fresh, wholesome food for all children at school. Mila Ferrer, type 1 diabetes advocate, blogger, and mother of Jaime, who was diagnosed at 3 years of age agrees. "In my family we do not eat any 'special' snacks or food. I’m a true believer that no food is forbidden if we learn to control our portions and when we can eat it."
7 Tips for an A+ Lunch
Nevertheless, it is important for parents of children with diabetes to have a few key points in mind to ensure they pack an A+ lunch all year long.
1. Focus on the carbohydrate
Food such as grains, fruit, starchy veggies and dairy all contain carbohydrates which the body uses as energy and cause elevations of blood sugar. Depending on the medication regimen, children with diabetes need to count carbs and administer the appropriate insulin. Children with type 2 might need to avoid excessive intake of carbohydrates or keep carbs consistent. This doesn’t mean eliminating carbohydrates, just be aware of them. A good tip is to write down the total amount of carbohydrates in a sticky note, to make it easier for the school nurse or for the child to count carbs at school.
2. Carry a fast-acting source of sugar to combat lows, at all times
For kids with type 1 diabetes, this is especially important since they require lifelong insulin injections which can cause blood sugars to drop. Options like juice, glucose tabs, milk, or a granola bar should always be available in the school nurse’s office and your child’s backpack. Children might not always be able to detect low blood sugars, so it's crucial school personnel can recognize the symptoms of low blood sugars and have a fast acting source of carbohydrate readily available.
3. Pack a lunch your child will eat
Makes sense right? But for children who receive insulin before eating, it’s especially important they eat something otherwise their blood sugars will plummet. “The goal is for the child to eat the packed lunch instead of trading with friends or not eating,” says White. Another helpful tip Mila Ferrer, project manager of Beyondtype1 and founder of Jaime mi Dulce Guerrero, follows is to include kids when planning lunches or snacks. “Go to the supermarket with them and every week try a new food. Kids get bored pretty quickly, this is a good way to change up the menu often.
4. Aim to include at least 3 food groups
Variety is key for all children. The My Plate method makes it simple—fill ½ the plate with veggies, some protein, source of whole grain and fruit. A typical meal for White’s daughter who has type 1 diabetes since age 6 is a whole grain bread sandwich, carrot or celery sticks, a piece of fruit, and healthy yogurt. “I recommend a piece of fruit instead of fruit snacks, send real food,” says White.
5. Include healthy snacks
Snacks for children are meant to supplement meals since they don’t always get all the key nutrients in three meals. Aim to provide high-quality foods, that don’t always come in a package. Good options include fresh or dried fruit, nuts or seeds, cheese and crackers or veggies with dips.
6. Consider sending low carb options
Some low-carb snacks should also be available Some children who don't receive injections for snacks might need to restrict carbs for snacks in order to avoid peaks in blood sugars. Or if a child with diabetes has a higher blood sugar before lunch, it can help to have a lower carbohydrate option which will not exacerbate an elevated blood sugar.
7. Water is the best drink
Except for low blood sugars, in which juice should be given, water should be the option of choice at all meals. Studies show that excessive juice or sweetened beverage consumption in children is associated with higher BMI and a higher risk for type 2 diabetes. So skip juices and sodas, give fresh fruit or a non-calorie drink.
A Week's Worth of Healthy Lunches
Sending a child with diabetes to school can be scary—you need to become your child’s advocate and ensure the school is equipped to provide a safe and nourishing environment. Packing a lunch can help parents better manage blood sugars because they can control lunch and carbohydrate intake.
Take the thinking out of the equation and destress this school year with these 5 healthy lunches—suitable for kids with both type 1 and type 2 diabetes.
Menu: Turkey Mini Burger + lettuce/tomato + 1/2cup strawberries (6 medium) + 7 apple chips + 1/3 cup pistachios.
Estimated Carbs: 47g
Menu: Beans/cheese and avocado on whole grain tortillas + 12 black bean chips + 1/3 cup blueberries + 7 carrots.
Estimated Carbs: 55g
Menu: Lettuce wrap with pork loin and side Asian vinaigrette + ½ pita bread + 1 tangerine + 8 dark chocolate pretzels.
Estimated Carbs: 43g
Menu: French Toast + ham and cheese + 1 tangerine + 1/3 cup blueberries.
Estimated Carbs: 30g Carbs
Menu: 1 extra large chicken tender, broccoli, 1/3 cup brown rice, 10 cherries.
Estimated carbs: 43g
Following these tips will help you improve your children's lunch boxes and your family's nutrition during school season.
Originally published in On Track Diabetes