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Carbs

Discussion in 'Parents of Children with Type 1' started by Junosmom, Dec 12, 2013.

  1. Junosmom

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    My son has always carried extra weight since his adenoids were removed when he was about 5. I wish I knew then...although I'm not sure what choice I would have made differently. He had "profound" hearing loss due to water on his ear, though not sick. He was very thin and had circles under his eyes. Dr. said instead of doing allergy testing, he thought son's immune system, that is his adenoids, were "overly active". I wonder now if this was a clue that he had an immune system on overdrive.

    At any rate, removing the adenoids and tubes removed resulted in an eating machine. He loves to eat, loves carbs. My husband and I are lower ( not no-carb, just lower) healthy eaters, and we model this to him and have all along. Exercise, eat well rounded, go easy on the carbs and eat the right type of carbs.

    So while in the hospital and since, the CDE's are saying he needs a significant amount more of carbs than we were previously feeding him. They suggest 60 - 70 per meal plus snacks. We were told that he is growing (he is but slowly right now) and that not feeding this amount of carbs could also affect brain development.

    At Endo appt this week, Endo said the way we were eating before was fine, and that yes, you need some carbs, but more of the 40-30-30 rule of carb-fat-protein. He did not think we have to have quite so many carbs. Wondering what advice you might give. Son is thinking that at least diabetes has the benefit of receiving more carbs per meal. :)

    If an adult chooses to, I can see that a lower carb diet would be advantageous, but don't want to hold back on carbs if it will hurt development. There is even a book (Bernstein, I think) that recommends low carb.

    He is right now 5' tall, 122 lbs.
     
  2. Sarah Maddie's Mom

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    He's only had D for a few months, I'm assuming the weight gain predates his diagnosis with Type 1, right? and the carb directive from the hospital was when?

    I'm just trying to understand if this is a sudden change, or a long standing situation and the extent to which D is a player.
     
  3. Christopher

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    In my opinion Bernstein and his "theories" should have nothing to do with children who have diabetes.

    In your case, since you are on a short acting/long acting regimen of insulin, there is no reason why you should have to change the way your son eats, whatever that may be, just because he has diabetes.

    That said, if the CDE's are saying that 60-70 carbs is significantly more than what you were giving him, you must have had him on a pretty low carb diet. I peronally don't like that for growing children, especially ones heading into puberty.
     
  4. Junosmom

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    History is that son was considered overweight for his height, but not obese, until the diabetes came on board. He had been looking a bit slimmer earlier in the year, as he picked up martial arts and started going 2 -4 times a week, that is, more exercise. Pre-diagnosis, his weight loss was misinterpreted by us as a result of exercise.

    He lost, then regained 9 pounds pre/post diagnosis. Now, the dr. and I am okay with his weight where it is, as it is predicted he will soon grow and has a potential to be of at least average, if not above average height (his dad 6'1", me 5'2", but he's always been 75 or more percentile).

    Perhaps it is just I've never counted carbs before now and didn't realize how many he ate before. We've had whole grain rice, whole wheat pasta, etc, but focused more on vegetables, salad, meat, with carbs as a smaller side dish. He's had milk, yogurt, etc. 60 - 70 just sounds like a lot. It looks like a lot.

    He loves, btw, any potato, potato chips, Bread with a capital B. :)

    So, I guess, my question is: how do you know how many carbs?
     
  5. Junosmom

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    Yes, he was overweight somewhat (belly mostly) pre-diagnosis and since age of 5 or 6.
    Carb directive from hospital was in September. He's regained the weight but is growing, too, so his body used some of that regained weight in height/growth, or at least, that is what it looks like.

    I don't think D has yet caused weight gain because of D. Trying to understand the suggestion to eat 60-70 carbs a meal. Is that a normal amount for an 11 year old?
     
  6. Christopher

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    60 or 70 does not seem like a lot to me for a growing young boy. If you think that is a lot, just wait until puberty is in full swing. :eek:

    Instead of focusing on the number of carbs or if it is "normal" or not, what about just trying to eat a relatively healthy diet? Protien, vegs, starches, etc. I think focusing too much on his eating habits may put him at risk for issues later on down the road.

    If his doctor and you are OK with where his weight is now, and he is otherwise healthy, then why not just relax and not focus on it so much?
     
    Last edited: Dec 12, 2013
  7. mamattorney

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    I have an 11 year old whose favorite foods tend to be very carby, so 60-70 a meal does not sound high to me at all, especially if you have a milk drinker.

    But it's all what's normal to you.
     
  8. Dave

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    Carbs raise blood sugar and high blood sugar causes organ damage and complications. Thats just a fact. It behooves all parents of diabetics to limit bad carbs. Jenny Ruehl has collected great research on this topic.
     
  9. RomeoEcho

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    Carbs are not in and of themselves bad. In fact they are quite necessary. They tend to get a bad rap these days because many of the carbs Americans eat these days are highly refined and processed, containing little if any nutrition and can easily exceed 100g per meal. But a lot of foods that are good for you also contain carbs. Try honestly counting the carbs in your diet for a week or so and you may be eating more than you think. 60 carb meals don't have to contain cookies, bread or pasta. Fruits, vegetables and real whole grains are healthy things we should be eating and all contain carbs. If he eats any dairy at all, it can add up rather quickly.
     
  10. RomeoEcho

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    I would clarify a couple things here:
    1. Carbs given without insulin raise blood sugar
    2. It behooves all parents of children to limit non-nutritious carbs.
     
  11. Christopher

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    Insulin lowers blood sugar and in range blood sugar keeps a person healthy. That's just a fact. It behooves all parents of children with diabetes to make sensible decisions about their child's diet and to ignore blanket statements on Internet forums.
     
    Last edited: Dec 12, 2013
  12. Dave

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    But insulin profile doesnt match food and you get a spike - everyone knows that. The more carbs, the bigger the spike the more damage. Ruehl site has documentation that extended spikes - I believe more than 2 hours - above 140 are bad. You can do an experiment. Feed your child 100g of oatmeal and bolus for it. Check their blood sugar at 1 and 2 hours. Now do the same but with 25g of oatmeal and bacon and eggs.
     
  13. Christopher

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    No, you cannot simply correlate the amount of carbs and the spike. The correlation is between the amount of carbs and the amount/timing of the insulin. If you time the insulin correctly, you should be able to minimize the spike no matter how many carbs you give. That is why many people use techniques like pre-bolusing, square wave bolusing etc, to match up the insulin and the carbs. Obviously, it is not a perfect science and people with Type 1 diabetes are going to get spikes no matter what they do.

    Your posts seem to be saying carbs are bad and the only way to reduce spikes is to limit carbs. I disagree with that. I personally think growing children need carbs and going low or no carbs is not the answer for me.

    As for the person you reference, do you mean Jenny Ruhl? The person who was diagnosed with Type 2 diabetes when she was 50 years old? The person who states she probably has MODY which is neither Type 1 or Type 2? The person who doesn't even use insulin to manage her diabetes? I am not sure how anything she is promoting bears any significance to our children with Type 1 diabetes. But if that is who you want to get your diabetes management philosophy from, go for it.
     
    Last edited: Dec 12, 2013
  14. Beach bum

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    And insulin lowers blood sugar. It's all a matter of timing the insulin and balance. So if my child was to have a big bowl of oatmeal, we let her, but we also balance it out with a glass of milk. The milk, oats and insulin along with a pre-bolus will only result in a minimal spike. If she has pizza, we will do light on the cheese and do an extended bolus over a few hours again, minimal to no spike.

    My daughter is very active with dance and right now, skiing. There is no way we will limit the amount of carbs she can have because her body needs them, not only for fuel for her muscles, but for her brain too. We know the facts that long term high blood sugars will result in organ damage. But working with her to know how to bolus food instead of restricting food will give her a good perspective on diet. We don't limit, but we also don't keep junk in the house all the time. I think if we became the food police, we'd be going down a slippery slope towards a love hate relationship with food.
    As for this comment:
    It behooves all parents of diabetics to limit bad carbs.

    It not only behoves parents of children with diabetes (I refuse to use the term diabetic, it puts a label on my kid), but any other kid out there. I have a feeling your idea of bad carbs and my idea of bad carbs are way off. I'm talking soda, donuts, chips, candy, over processed foods. Do my kids eat them everyday? Nope, once in a while. I think it's more important to teach them that it's ok once in a while, not everyday, and if you do have something like that, be prepared to watch what you eat the rest of the day. It's a matter of teaching them common sense when it comes to food choices.
     
  15. hawkeyegirl

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    People with type 1 have higher rates of heart disease than the general population, so I am not sure I would go around advocating a bacon and eggs diet. Additionally, we frankly often have an easier time matching insulin to carbs with carby meals than we do meals with lots of protein/fat.
     
  16. nebby3

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    My 11yo dd is about the same-- 5 feet tall and 120 lbs. I am not sure of the specifics but that is about right. Her 3 non-D siblings are all thinner. The only real difference in their diets is when we have to treat lows. But I don't think that is responsible for all her weight. She has had D 10 yrs and has so has had her BMI done 4x a yr for that period at the endo's. Her BMI had always been about the same. They keep an eye on it but don't worry; they say it's just the way she is. We do limit carbs somewhat. High carb breakfasts don't work well and neither do dinners really. But it's not to control her weight, just to avoid spikes. She knows not to have too many carbs at breakfast; at dinner I just try to cook low carb for the whole family. I don't draw attention to it. She loves her carbs though. I think she is a potato addict. I wouldn't tell a kid we are limiting carbs but I would cook lower carb and buy healthy snacks. That is good for the whole family. At age 11 I not too concerned about low carb affecting brain development like I would have been at age 1 or even 5. Btw between her snacks and lunch her diet is probably not low carb overall.
     
  17. missmakaliasmomma

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    i agree with this. My 5 year olds dinner is about 50g. If you think about it, at mcdonalds, a 4piece nugget and small fries is 45ish (depending). I'm sure that nowhere near fills a growing boys stomach. Just because he has to eat more carbs, doesn't mean he can't still eat healthy. You can choose lower GI options which are typically a little better. It's what we do for my daughter to help minimize the spikes- food with a decent amount of fiber, protein and foods that you actually have to cook (lol). There's a lot out there, you just have to search for it. There are easy changes to make that make a difference like brown rice instead of rice... it's simple but it works a lot better with my daughter's BGs.

    While I don't believe in completely changing eating habits due to D per say, it definitely opened the light that we should all eat healthier and that's the choice we decided to make. Nobody needs 100g of sugar a day (well I'm a coca cola fiend so I do :rolleyes: but I'm not a good role model when it comes to that lol) ...Does she still get cookies and mcdonalds? Yes, but not everyday.
     
  18. quiltinmom

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    What is meant by "limit?" Does it mean eliminate? Or is it okay to have sometimes? So how often? Also a definition of "bad carbs" would be helpful. "Bad" is a matter of opinion, not fact. Not to be a stickler or anything. :) I think we all know that pure sugar is "bad" carb. But some foods are debatable (like bananas, or potatoes, for example). I'm not trying to contradict by any means. In fact, parents of every child should limit bad carbs (i.e. nutritionless foods), regardless of other health concerns.


    To the OP--I am not a nutritionist. I am not saying I recommend feeding your kid the way I do. I just want to say, for comparison, it is rare that my almost 12 year old son eats less than 60 carbs in a meal. It happens, but not that often. I think his daily carb average is somewhere between 250-275. Some days it is above 300. He is a growing boy. He is always hungry. He loves carbs too. He also loves cheese. (he said, "can I ask for a block of cheese for my birthday? lol I said no, btw. :) ) I haven't researched this specifically, but my gut tells me that a growing boy needs a different diet than a fully grown adult. Their growing, developing bodies will need more energy from carbs than an adult. Aren't all boys eating machines? That sounds pretty normal to me. Perhaps it's because you have older daughters and aren't used to the amount of food a boy will eat compared to a girl.

    When a boy is hungry, you gotta feed him! So 60 carbs at a meal doesn't seem like too much to me. I think the quality of carbs is more important than the number.

    Instead of specifically planning meals around carb count, I try to serve a varied, nutritious diet to my family, and let the carb count fall where it may. Our diet could probably be improved upon, but we do our best. Maybe I'm a slacker. Maybe I think this way because it's too hard to figure out what the "right" number of carbs is. I just don't have the mental/emotional energy to drive myself nuts over this one thing. There are too many other things I have to do. (Call that a lame excuse, if you will.) When we see his endo, he doesn't say anything about eating too many carbs. DS is a healthy weight, so I figure we must be doing something right.

    Among my extended family there is a LOT of talk about food....and what it boils down to is that you have to figure out what is right for your family. Don't we all wish there was just one right answer...but there isn't. The hard part is figuring out what is right for you. It can be a hard balance to strike between healthy eating and letting your child eat what he/she wants and avoiding diabetes related things like lows or spikes. If food weren't so emotional for us, this would be a lot easier.

    So do your research, search your heart, come to a decision, and don't feel like you have to apologize to anyone about it.
     
  19. Mwills27

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    My ten year old son eats approximately 60g of carbs per meal. Honestly, that's based on how he ate prior to his dx at age 7 although I think it's naturally gone up about 10g through the years.

    When my son was diagnosed our hospital team did a great little exercise with us. My son and I wrote down what an avg days meal plan looked like. The nurse helped us figure out the carb count of what we were used to eating and that's what we based his initial insulin routine on.

    The simplest advice I could give you is to eat the same way you did prior to diagnosis.The diabetes diagnosis should not change the way you eat in any staggering way. Every family is different in their eating patterns and nutritional value of their meals. If you considered your son's previous diet to be healthy then I'd stick with that.

    Dieting is not recommended for most children unless it's physician recommended. Severely limiting any food group is probably not a good idea. If you feel your son has a weight problem it might be good to work with your Doc and dietician on a healthy way to tackle that. However if my memory serves me right my son ate like a horse for a few months after diagnosis and I remember being told that was common in newly diagnosed children.
     
  20. Junosmom

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    Thank you for all the posts and continuing the discussion.

    For clarity on my part:

    We've always focused on eating healthy and making good choices. We eat lots of fruits and vegetables, chose better cereals, ate brown rice mostly and whole wheat pastas. We do eat meat. We occasionally would have potatoes but not at every meal - like while I grew up. :) I put food on the table - you can choose from what is there. We have, imo, a better diet than most people I know.

    I have never used the word diet with my son in the sense of diet to lose weight. He has never been on a diet. We have always told him that his weight was a function of eating, exercise and choices, but that much of his weight would come off when he grows. He doesn't, I think, get as much running around as most kids (several factors), but in June, started tae kwon do and I take him at every opportunity - as many as four times a week.

    I am aware of, especially with D, the need to be careful of not making food an issue/fight. Dh and I work ourselves to maintain a healthy weight, and are, and perhaps we were eating lower carb than son needs, but I wasn't sure, which is why I asked. I've never counted. Son also sees two first cousins, one 17 and one 21, that are morbidly obese (two different families). His own concern with weight is that he doesn't want to be like them. I assure him all the time that his growth and exercise will grow him into a healthy weight.

    I only brought the weight up because I don't want to add to it, not decrease what it is now. I appreciate those of you that have said that your child is eating 60 - 70 at this age. It is reassuring.

    And for those of you using the word "behooves", when ever I hear "there be hooves", I can't help but think there are some bulls around. Let's please be kind. I'm seeking information - I'm learning. I'm trying with everything I have to be the best mom I can be.
     

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