Low Carb diet for children

eshobabu

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I know a lot of T1s maintain excellent sugar control by simply eating less carbs <30g a day. This is contrary to the advice we were given when leaving the hospital. We were told my 6 yr old T1 daughter needs 45-60 g carbs PER MEAL. Works out to around 130-180g carbs a day.

We try to stick to around 100g carbs a day. She is in honeymoon now so we have done this without any insulin for 3 days. I do see it spike to around 200-250 but it always comes back down within 2-3 hours. I wonder if I further reduce the carbs, would it harm her? Is there research on low carb diets for diabetic kids - long term growth issues? Once she is an adult she can certainly do keto - but she's just 6 now.
 

Goonergal

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@eshobabu

A ketogenic diet is sometimes used for children with epilepsy and I don’t think it is inherently bad for children. However it would add a layer of complexity to managing a newly diagnosed case of type 1 in a child. If you’re interested I’d suggest finding a doctor with an interest in the area that understands type 1.

Dietdoctor.com maintains a list of clinicians around the world that have an interest in low carb eating: https://www.dietdoctor.com/low-carb/doctors/

In the UK, the Public Health Collaboration does the same: https://phcuk.org/map/
 

ert

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I know a lot of T1s maintain excellent sugar control by simply eating less carbs <30g a day. This is contrary to the advice we were given when leaving the hospital. We were told my 6 yr old T1 daughter needs 45-60 g carbs PER MEAL. Works out to around 130-180g carbs a day.

We try to stick to around 100g carbs a day. She is in honeymoon now so we have done this without any insulin for 3 days. I do see it spike to around 200-250 but it always comes back down within 2-3 hours. I wonder if I further reduce the carbs, would it harm her? Is there research on low carb diets for diabetic kids - long term growth issues? Once she is an adult she can certainly do keto - but she's just 6 now.
Unfortunately, in my opinion, no one is advised as a type 1 to eat a low carbohydrate by our medical professionals. I recommend joining the FB group typeonegrit.
There is evidence that low carb, which means a lot more vegetables rather than processed foods, is better nutrition for children.
https://www.diabetes.co.uk/diet/children-and-low-carb-diets.html#:~:text=For children with type 1,be followed safely by children.
 
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EllieM

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What does SHE want to do

I wouldn't restrict her too much as she may grow to resent you for it xx

A six year old is pretty easily influenced by her parents, but I would be concerned about a very restrictive diet for a child - restrictive diets, at least in older children, can result in eating disorders, and you really really don't want to go there.

But as a family, you can influence what your child eats by just not having the higher carb stuff in the house....
 
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KK123

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Hi, it's a tricky one for sure because you want to make sure your daughter has all the nutrition she needs at that age and I'm not sure whether a very low carb diet (as in VERY strict/keto) would be suitable. What are her meals made up of now?, I'm guessing she doesn't eat sweets galore and the obviously high sugar items (cakes, chocolate bars and so on). I think I would stick low carb (which you are already doing) but stick to the 'healthier' carbs, yes I know, many adults on here say there is no such thing and that's fine, a person can survive without them but a 6 year old I'm not sure that's doable. On a keto diet I wonder what meals you would feed her? Under 30 carbs is very restrictive I feel. Having said that, I'm thinking that it would actually be very difficult to feed a 6 year old up to 60 carbs a meal based on healthy meals?, the portions of carbs would be huge. x
 
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Resurgam

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I brought up two ordinary children of a fairly low carb diet and they were/are absolutely fine, both have become tall slender adults - neither had acne as teenagers. Even as tots, though, they would far rather have minced beef than chips, and once they could open the fridge my boiled eggs were gone, the roast chicken lost its legs and the cooked meat had teeth marks.
 
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DCUKMod

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I know a lot of T1s maintain excellent sugar control by simply eating less carbs <30g a day. This is contrary to the advice we were given when leaving the hospital. We were told my 6 yr old T1 daughter needs 45-60 g carbs PER MEAL. Works out to around 130-180g carbs a day.

We try to stick to around 100g carbs a day. She is in honeymoon now so we have done this without any insulin for 3 days. I do see it spike to around 200-250 but it always comes back down within 2-3 hours. I wonder if I further reduce the carbs, would it harm her? Is there research on low carb diets for diabetic kids - long term growth issues? Once she is an adult she can certainly do keto - but she's just 6 now.

eshobabu - whilst it might be possible to have your daughter maintain decent cntrol on a reduced carb diet, I would urge you to consider a few things.

Firstly, how would your daughter feel about having another part of her life restricted? From memory, she doesn't like injecting (who would?), and wants to be "better". How would she feel about having to continue to inject (smaller or doses, perhaps, although if she is in honeymoon, that may not even happen over time), and not be allowed chocolate, rice, pasta or whatever else you decided to reduce or exclude. Would that not just be another sign of how different she is from her friends?

Whilst there probably aren't too many play-dates happening at the moment, but were she invited to a little friend's house for a few hours to play and was offered chocolate, icecream, biscuits, or whatever, would you expect her to accept or decline it, and how would you feel if she had several biscuits (or whatever). There's nothing so sweet as the forbidden fruit.

I've mentioned in the past the kids group that runs from our local hospital. Our local group decided to give them a sum of money, to use as their "leaders" chose. Their leaders are hospital paediatric SDNs.

They were delighted to receive the cash, and it was used to fund a trip to Cadbury World, in Birmingham. Initially I was a bit astonished, but that was the choice, to demonstrate to the kids they can do all things other kids can, and have a great time.

I'm not saying low carb is a bad idea for kids, I'm just saying it is worthwhile looking to the bigger picture and to a l esser extent the longer term.
 
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NicoleC1971

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I know a lot of T1s maintain excellent sugar control by simply eating less carbs <30g a day. This is contrary to the advice we were given when leaving the hospital. We were told my 6 yr old T1 daughter needs 45-60 g carbs PER MEAL. Works out to around 130-180g carbs a day.

We try to stick to around 100g carbs a day. She is in honeymoon now so we have done this without any insulin for 3 days. I do see it spike to around 200-250 but it always comes back down within 2-3 hours. I wonder if I further reduce the carbs, would it harm her? Is there research on low carb diets for diabetic kids - long term growth issues? Once she is an adult she can certainly do keto - but she's just 6 now.
I suggest you take a look at TypeOnegrit facebook which gets excellent results using low carb for type 1s without the hypos and in some cases preserving beta cells for longer than the usual honeymoon period.
It is perfectly healthy and she may only feel deprived if you as her family continue to eat carbs. For that reason I'd think carefully if you wanted to do this as a family. There'd be health benefits all round and cooking would be simpler but its a big step to ditch bread, pasta, rice, cereals etc.
 

eshobabu

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All of you have made excellent points - I am very glad you pointed me those two artciles the part that scares me is this.
: "There is currently a lack of clinical studies into low-carbohydrate diets for children with diabetes. Low-carb and ketogenic diets appear to show no significant issues in terms of safety for children in general though.". From the link to the published research - "Exceptional glycemic control of T1DM with low rates of adverse events was reported by a community of children and adults who consume a VLCD". What I am unable to find, is long-term effects of VLCD on kids. Does it at all harm them? Why is my medical team saying she needs 150-180 g of carbs a day and things like her brain needs carbs to function?

So back to what a lot of you are saying - restricting her further. You are right - I hate doing it. And I dont intend to completely go <30g. I am more concerned about what I am doing now - around 90g and not 150g that the doctors say. We dont have any sugary things in the house at all, so all her carbs are from brown rice, whole wheat bread, veggies and milk. Since there is no cake, chocolate, and juice at all in the house (except strategically placed hypo supplies) - the thing about children, out of sight out of mind. Once a week or so we will go out and she will binge - like yesterday we had pancakes and she shot up to 360 :-( so we had to give insulin. If she were to go to a birthday party or something, it would be similar. Exceptions like that are fine - we are not going to put her in a bubble. I am more talking about normal day to day routine outside of events like these. And it would be the entire family not just her - I myself eat only once a day and exactly what she is eating - so its not like its just her being left out. Since her diagnosis, we have all eaten healthier and exercised more!

The part that I am deeply confused about is where an entire community of people is attesting that they raised their kids with excellent glucose control on LC diets (I saw TypeOnegrit ) just fine and medical professionals telling me her brian needs 180 carbs a day to function - something just does not add up there.
 
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TypeZero.

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I know a lot of T1s maintain excellent sugar control by simply eating less carbs <30g a day. This is contrary to the advice we were given when leaving the hospital. We were told my 6 yr old T1 daughter needs 45-60 g carbs PER MEAL. Works out to around 130-180g carbs a day.

We try to stick to around 100g carbs a day. She is in honeymoon now so we have done this without any insulin for 3 days. I do see it spike to around 200-250 but it always comes back down within 2-3 hours. I wonder if I further reduce the carbs, would it harm her? Is there research on low carb diets for diabetic kids - long term growth issues? Once she is an adult she can certainly do keto - but she's just 6 now.

I wouldn’t put any restrictions on your daughter. You can certainly cook low carb food to help her in her honeymoon but ultimately the honeymoon is going to end so it wouldn’t matter whatever she ate. Remember we can eat anything we want as Type 1 diabetics, anything, we just need to give insulin appropriately and a certain amount of x minutes before eating.

But i don’t think low carb should do any harm or affect growth as long as your daughter is getting the appropriate nutrients and energy
 
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kaylz91

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I eat about 100g carbs a day, a typical day for me is
Breakfast - oats and peanut butter
Dinner - a wholemeal sandwich with whatever filling and then after that I'll have a cake bar or a chocolate biscuit or even a chunky pb kit kat
T - potatoes, veg and whatever meat/fish there is or twice a week I'll have omelette with it, every evening I'll have 1 square 95% chocolate or 3 times a week I'll have a 25g bar of 85% chocolate
It's taken me a lot to get where I am now as I suffered an eating disorder after my Type 1 diagnosis due to a low carber Type 1 telling me I was doing wrong by eating carbs, we all tolerate different things but I missed out on so much when I was suffering the most with my disorder (irrational fear of carbs) so much so I wouldn't have a birthday treat, no dessert at christmas etc, I wouldn't limit her anymore personally, she'll already see herself "different" to her friends and limiting her more would make it even worse for her, its physchological impact you have to think about too xx
 
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DCUKMod

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I wouldn’t put any restrictions on your daughter. You can certainly cook low carb food to help her in her honeymoon but ultimately the honeymoon is going to end so it wouldn’t matter whatever she ate. Remember we can eat anything we want as Type 1 diabetics, anything, we just need to give insulin appropriately and a certain amount of x minutes before eating.

But i don’t think low carb should do any harm or affect growth as long as your daughter is getting the appropriate nutrients and energy

To be honest, I'm not sure I understand your point about the honeymoon period. I know I mentioned it myself, in the context that insulin doses may increase over time, due to the honeymoon period ending, but not sure of your point.
 

eshobabu

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I eat about 100g carbs a day, a typical day for me is
Breakfast - oats and peanut butter
Dinner - a wholemeal sandwich with whatever filling and then after that I'll have a cake bar or a chocolate biscuit or even a chunky pb kit kat
T - potatoes, veg and whatever meat/fish there is or twice a week I'll have omelette with it, every evening I'll have 1 square 95% chocolate or 3 times a week I'll have a 25g bar of 85% chocolate
It's taken me a lot to get where I am now as I suffered an eating disorder after my Type 1 diagnosis due to a low carber Type 1 telling me I was doing wrong by eating carbs, we all tolerate different things but I missed out on so much when I was suffering the most with my disorder (irrational fear of carbs) so much so I wouldn't have a birthday treat, no dessert at christmas etc, I wouldn't limit her anymore personally, she'll already see herself "different" to her friends and limiting her more would make it even worse for her, its physchological impact you have to think about too xx


Thank you for your insight. I never really considered the psychological impact and irrational fear of carbs, as well as eating disorders. Thinking back, her diet is not all that different from what she had before. The only difference is I used to give her a lot of juice and chocolate milk thats no longer in the house so she does not ask for it as much. She only asks for things that she sees - so its not so much me denying her, but not having those things so she does not want them... We also cook more at home do not order from fast food restaurants as much anymore, which is good for the entire family. With brown rice, whole wheat bread, veggies, protein and regular milk - she eats till she is full and still comes in at around 90g carbs a day.
 

NicoleC1971

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All of you have made excellent points - I am very glad you pointed me those two artciles the part that scares me is this.
: "There is currently a lack of clinical studies into low-carbohydrate diets for children with diabetes. Low-carb and ketogenic diets appear to show no significant issues in terms of safety for children in general though.". From the link to the published research - "Exceptional glycemic control of T1DM with low rates of adverse events was reported by a community of children and adults who consume a VLCD". What I am unable to find, is long-term effects of VLCD on kids. Does it at all harm them? Why is my medical team saying she needs 150-180 g of carbs a day and things like her brain needs carbs to function?

So back to what a lot of you are saying - restricting her further. You are right - I hate doing it. And I dont intend to completely go <30g. I am more concerned about what I am doing now - around 90g and not 150g that the doctors say. We dont have any sugary things in the house at all, so all her carbs are from brown rice, whole wheat bread, veggies and milk. Since there is no cake, chocolate, and juice at all in the house (except strategically placed hypo supplies) - the thing about children, out of sight out of mind. Once a week or so we will go out and she will binge - like yesterday we had pancakes and she shot up to 360 :-( so we had to give insulin. If she were to go to a birthday party or something, it would be similar. Exceptions like that are fine - we are not going to put her in a bubble. I am more talking about normal day to day routine outside of events like these. And it would be the entire family not just her - I myself eat only once a day and exactly what she is eating - so its not like its just her being left out. Since her diagnosis, we have all eaten healthier and exercised more!

The part that I am deeply confused about is where an entire community of people is attesting that they raised their kids with excellent glucose control on LC diets (I saw TypeOnegrit ) just fine and medical professionals telling me her brian needs 180 carbs a day to function - something just does not add up there.
I think the contention that she needs xg of carbs day comes from the wrong idea that the brain runs on glucose and that this glucose must come from carbohydrates. The former is partly true but the latter isn't.
As a type one diabetic her liver will produce glucose (gluconeogenesis) and the lack on insulin is the main problem for her in that her liver carries on making glucose with no insulin to stop it.
If you think about how long you can go without food (you eat a meal at 7pm and then skip breakfast and don't eat again until lunch yet still your brain carries on working). You would be hungry and so would your daughter so I am not suggesting this just illustrating the fallacy that a certain amount of carbs are 'necessary'. Some dieticians also contend that she will need non soluble fibre from the wholegrains and might prefer to get them this way rather than from green veg?
As others point out if you can minimise hypos, not single her out with a special diet and get her sugars mainly low by what you are doing that's fine. She will be getting regular heights/weights taken at her clinic and it is actually having higher blood sugars and not lower carb which would inhibit her growth.
 

Resurgam

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Why is my medical team saying she needs 150-180 g of carbs a day and things like her brain needs carbs to function?
The part that I am deeply confused about is where an entire community of people is attesting that they raised their kids with excellent glucose control on LC diets (I saw TypeOnegrit ) just fine and medical professionals telling me her brian needs 180 carbs a day to function - something just does not add up there.
It is confusing because you (and those telling you about it) are thinking that there must be some direct link supplying glucose to the brain straight from the gut and so there must be carbohydrate in the diet and a constant input too. How they think it is possible to survive 12 hours not eating must be interesting.
Glucose is released into the blood as required - fat is broken down protein can be used too - but it is not sourced from food and nowhere else.
 

TypeZero.

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To be honest, I'm not sure I understand your point about the honeymoon period. I know I mentioned it myself, in the context that insulin doses may increase over time, due to the honeymoon period ending, but not sure of your point.

What I’m trying to say is that they can take advantage of the honeymoon and live insulin-free if they go low carb. That way they would have a much more comfortable honeymoon, that’s the only reason why I think they could try low carb for now.

But obviously moving forward as honeymoon ends insulin is a necessity regardless of whether you eat 30g of carbs a day or 300
 

eshobabu

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What I’m trying to say is that they can take advantage of the honeymoon and live insulin-free if they go low carb. That way they would have a much more comfortable honeymoon, that’s the only reason why I think they could try low carb for now.

But obviously moving forward as honeymoon ends insulin is a necessity regardless of whether you eat 30g of carbs a day or 300

Not just that - post honeymoon with more carbs = more insulin = more chances of getting the dosage wrong = more hypo, hyper.

during honeymoon = less carbs + little bit of insulin = less strain on the remaining islets = longer life for the islets.

Basically, will 90g carbs (or slightly less than that) result in any long term growth inhibition? There is a lot of research that leads me to believe this is not a problem for adults - just the lack of research on what this will do to a 6 year old child is what concerns me.
 

Daibell

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I think what you have been told is just the normal NHS advice following an unproven 'party line'. I suspect you will find it difficult to came across any evidence saying there is a minimum amount of carbs for a child to eat based on valid research. Any person, child or otherwise, needs a mix of fats, proteins, carbs, veg and fruit etc but carbs are not as important as the other foods (in my opinion).