By Marsha N. Woolery
Diabetes in children is increasing in Jamaica. This increase may be as a result of, or a combination of, factors such as reduced breastfeeding, more television watching, less physical activities, poor eating habits (all of which may result in increased body weight) and an increased awareness and blood-sugar testing among children and youths.
Every year, the International Diabetes Federation, Ministry of Health (Jamaica), the Diabetes Association of Jamaica and other interest groups celebrate World Diabetes Day on November 14. This year, the theme is 'Diabetes - Protect our Future', which focuses on educating, engaging and empowering youth and young adults. The current trend of overweight/obese, inactive children should not be encouraged and, thus, parents and caregivers, teachers and children alike, must be empowered with information about the prevention or delay of onset and the management of diabetes.
Do fewer indoor activities
Diabetes can be prevented or delayed in children or young people by encouraging 30 to 60 minutes of physical activity every day, doing fewer indoor activities such as watching of television and playing video or computer games, and eating less fatty, sugary, salty and refined foods such as sausages, fried foods, margarine, mayonnaise, fried snacks, sweet or salty snacks, bottled and box drinks, 'bag juice' and candies.
Children should be provided healthier alternatives such as fresh fruits and vegetables that are high in fibre, natural sugars and loaded with vitamins and minerals; unrefined staples such as yam, banana, old-fashioned oats, and sweet potatoes; fresh unprocessed meats, chicken, fish, cheese, eggs and low-fat milk, and peas and beans that are high in fibre, protein and iron and low in fat.
The goals of nutrition in the management of diabetes in children are to maintain steady growth, appropriate weight gain and development; achieve and maintain blood-sugar level as close to normal as possible, maintain glycated haemoglobin (HbA1c) at less than seven per cent, maintain normal lipids and blood pressure to prevent heart disease.
These goals may be achieved by choosing low-fat, low-sugar, high-fibre foods; eating three balanced meals and snacks per day; and taking medication, whether insulin or oral glucose-lowering tablets, along with at least 30 minutes of exercise daily. Blood sugar should be checked two to three times per day.
Structure meal times
Mealtimes should be structured — breakfast, lunch and dinner with low-fat, low-sugar snacks ( especially if on insulin) such as crackers, bread or bun with cheese, peanut butter, milk (cow or soy), fruit smoothie made with milk or yoghurt, lightly buttered popcorn with fruit. Meals or snacks should not be skipped or missed as this could result in low blood sugar.
Low blood sugar may also occur if too much physical activity is done or too much medication was taken or too little food was eaten. It is treated by drinking juice, eating sugar, glucose or candy to increase the blood sugar, followed by a snack or meal to keep blood sugar normal. Low blood sugar should NOT be treated with milk, chocolate or a high-fat food item.
Children should be taught to make healthy food choices, especially for times when they are away from home. Children would benefit from attending specially designed residential camps such as Jamaica's own Camp Yellowbird, held every year in the third week of July.
Upon diagnosis, children with diabetes, along with their families, should receive diabetes education to improve quality of life and delay the complications of diabetes.
Marsha N. Woolery is a registered dietitian/nutritionist in private practice and adjunct lecturer at Northern Caribbean University; email: firstname.lastname@example.org.