There have been drastic changes over the last 3 decades with regard to the dietary recommendations for people with diabetes. Before 1994, nutrition recommendations were set forth for all people with diabetes with little regard to the individual’s lifestyle. After 1994 and consistent with the 2002 American Diabetes Association (ADA) evidence-based guidelines, the emphasis shifted from a strict focus on dietary components to a focus on maintaining target blood glucose levels and a lipid profile and blood pressure that reduce the risk of chronic disease. The current ADA nutrition recommendations for children and adolescents with type 1 diabetes share these goals and also focus on adequate nutrient intake for growth and development. These recommendations are based on the requirements for nondiabetic children and adolescents that are collected in the Dietary Reference Intakes, which update and expand the recommended dietary allowances (RDAs).

Only a few studies have examined the diets of children with type 1 diabetes, and even fewer have compared those diets with children without diabetes. In terms of energy intake, two studies of children with type 1 diabetes found that energy intake was lower than recommended; one study found that children met the RDA, and a fourth study found that male subjects met the RDA but female subjects had energy levels below the RDA. Two studies compared the energy intake of children with diabetes with that of matched control subjects. One study found that the intake of children with diabetes fell below that of control subjects who met the RDA, and the other study, based solely on girls, found no difference between children with diabetes and control subjects in energy intake, with both groups reporting lower intake than predicted by energy expenditure.

Studies have also examined the components of dietary intake. Carbohydrates are an important consideration in the diets of children with type 1 diabetes, as they are the principal source of energy but require appropriate amounts of insulin to be utilized by the body. Four studies found that children met carbohydrate requirements, and one study found that children had a lower carbohydrate intake than recommended. In the two studies that included a comparison group, children with diabetes had a lower carbohydrate intake than age- and sex-matched control subjects.

We live in a world where preventable diseases are affecting more people every year. In fact 24 million Americans have diabetes. At the current rate, one out of every three people born in 2000 will develop diabetes, putting them at higher risk for other medical problems. What is going on? It cannot be all about genetics. Something in our day-to-day lives is making us sicker.

Before pointing fingers, let’s look at what diabetes is. It’s a disease in which the body does not produce or properly use insulin-a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. A common precursor to diabetes is hypoglycemia-the body’s inability to handle large amounts of sugar. Hypoglycemia can be caused by an overload of sugar, alcohol, caffeine, tobacco and stress. This condition is triggered when the pancreas secretes too much insulin in response to a rapid rise in blood sugar, which in turn causes blood sugar levels to plummet, starving the body’s cells of needed fuel. When we need fuel, our body’s natural response is to crave something sweet, and that is where we get into trouble.

Most people’s reaction when they crave something sweet is to run to the vending machine for a candy bar or soda. This fix may provide instant gratification, but it can cause your blood sugar levels to spike right after a meal and then crash to abnormally low levels several hours after a meal. This roller-coaster effect is implicated in the onset of type 2 diabetes. It may take years for hypoglycemia to develop into full-blown diabetes, so the earlier you intervene the better.

Since overconsumption of refined sweets and added sugars has led to the increase in obesity, hypoglycemia and diabetes, diet is an important preventative measure. We’ve got to literally clean up the junk in our diets. I like to say, eat less sugar and chemical-filled artificial junk food, more vegetables, whole grains and fruit. Instead of that doughnut for breakfast, try a complex carbohydrate like oatmeal for sustainable energy. By eating something without added sugar your body will be able to maintain its natural balance and you will be less likely to crave those processed sweets. Another way to think about it is to eat less food in brightly colored packages and boxes and more colorful foods from the produce section.

Sugar cravings are as natural as our desire for air, so let’s not fight our body’s natural instincts. Instead of hitting the vending machine for sweets, alleviate your cravings with these naturally sweet foods:

• Corn
• Carrots
• Onions
• Beets
• Sweet potatoes
• Yams
• Turnips
• Red cabbage

Doctors are realizing the importance of exercise in preventing disease as well. Exercise doesn’t have to be going to the gym every night. It could be taking a walk, parking at the back of a parking lot, taking the stairs, or going out dancing. Find ways you like to move and you will also help prevent your body from breaking down. By incorporating more movement into your daily routine, as well as more whole foods, you will be less likely to need operations and medications later on in life.