An epidemic of excessive weight and obesity has taken hold among children, resulting in more type 2 diabetes in children than ever before. Several factors are responsible for this epidemic, including
Consuming high fat foods
Drinking large amounts of high calorie fruit drinks and other caloric beverages
Increasing time spent in front of the TV and the computer and not exercising
Children pay a high price for their overweight condition in the form of low self-esteem and less acceptance by their peers, not to mention the risk of developing type 2 diabetes.
For overweight children, the old joke about being too short for your weight really is true. Children often grow out of their overweight condition. As a parent, your job is to help them maintain their weight until they grow older and taller, not necessarily to help them lose weight.
Setting an example
Children resemble their parents not just because of the physical resemblance but also because children pick up their parents' mannerisms. Your children are constantly studying you. They follow the example you set with your eating. If they observe you overeating and dieting, they assume that is the appropriate way to eat.
You set a dietary example by eating the same foods that you want your child to eat. You set an example by keeping the quantities of food you eat moderate and by choosing food that is low in fat and salt and high in fiber. You set an example when your child observes that exercise is a part of your daily routine.
Involving children in food preparation
When you ask children to describe their earliest memories, they often talk happily about helping their grandmother make some kind of food. Preparing food together can be a great bonding experience between you and your child, which also provides you with the opportunity to teach good nutrition. If you follow a recipe and tell your child to measure half the fat listed in the recipe or to leave out the salt altogether, that lesson stays with the child for life.
Have your child create his or her own nutrition plan for a day and discuss every part of it, pointing out what is carbohydrate, protein, and fat, the balance among those foods, and how they affect his or her diabetes. Use the food guide pyramid or the child's nutrition plan as a guide for planning.
Missing no meals
Your child must know that missing meals is not appropriate for many reasons. If he has type 1 diabetes, a missed meal is a fairly certain prelude to a hypoglycemic (low blood glucose) reaction. Breakfast is especially important because he or she is going from the fasting (sleeping) state, when energy needs are minimal, to the state of activity, when calories are essential. Your school-age child will have trouble with morning classes when no food energy is available.
A second problem associated with a missed meal is the extreme feeling of hunger that leads to overcompensating during the next meal. Overeating at that meal can make your child go from low to very high blood glucose very rapidly.
Finally, the lesson that your child receives when he or she misses meals is that irregular eating is acceptable. The best way to encourage weight control is to teach regular eating of smaller meals and snacks, which is a program that anyone can follow for life and be fairly certain of getting good, balanced nutrition. After the initial weight loss, people rarely continue to succeed when their weight loss program calls for missing meals.
Involving the child with the dietitian
The dietary needs of growing children are complicated enough, but when you factor in diabetes as well, the situation may be beyond the knowledge of a parent. When you feel overwhelmed, call on the dietitian, but always with the child present. A nutritional plan for diabetes is not something you impose upon your child, but something you work out together with your child.
You and the dietitian must take your child's food preferences into consideration. If you don't, your child will not likely follow any plan that you devise with the dietitian.
Keeping problem foods out of sight and good foods in easy view
If potato chips or creamy cookies sit on the kitchen counter, can you blame your child (or yourself) for grabbing a handful every time he or she goes by? Don't buy these foods in the first place, but if you do, keep them out of sight. You know what happens when you walk up to a buffet table. You can more easily avoid what you don't see.
On the other hand, keep fruits and vegetables in plain sight, along with other acceptable snacks like air-popped popcorn. Having a special device for drinking water is a good idea, too, because it turns water into something special and, therefore, more desirable. Even having a pitcher of water in the refrigerator beats going to the sink, where the association is with washing hands and dishes rather than nutrition.
Monitoring TV food ads with your child
Like it or not, your child spends a certain amount of time in front of the television every day. The ads that he or she views are most likely for high-calorie, high-sugar, high-fat snack foods. Sitting with your child for some of the viewing time and discussing the nutritional content of the food is important and valuable. Even if you keep that kind of food out of your food basket and your house, your child will eventually go to a friend's home and find that food.
Your child should learn from poor food choices by seeing the effect upon his or her blood glucose. Such an observation may be enough to prevent your child from making that particular choice again. On the other hand, you never want to nag your child about eating off the nutritional plan. Rather, you should accept the misstep and tell the child to move back to appropriate eating with the next meal.
Enlisting expert assist
You can make use of expert advice to help with your child's nutrition. The American Diabetes Association and the Juvenile Diabetes Foundation both offer plenty of food-related materials, as do many other organizations. You can find them through Dr. Rubin's Web page.
One of the more valuable resources is the American Dietetic Association, which also has a Web site (available through Dr. Rubin's site). They can provide nutrition plans, recipes, nutritional analysis of foods, and other useful information.