Nutrition for Children and Adolescents with Type1 Diabetes

Why the Mediterranean Diet?

The Mediterranean dietary pattern is rich in fruits, vegetables, whole grains, legumes, nuts, olive oil, and fish, with moderate dairy and limited red meat and added sugars. Research shows that this eating style improves glycaemic control, reduces cardiovascular risk, and supports healthy growthkey concerns for young people living with type1 diabetes (T1D).

Core Principles for Young People with T1D

• Balance carbohydrates with insulin. Portion size and type of carbohydrate determine the insulin dose.
• Emphasise lowglycaemic index (GI) foods. Most Mediterranean foods have a lowtomoderate GI, leading to smoother postmeal glucose excursions.
• Include healthy fats. Monounsaturated fat from olive oil and polyunsaturated fat from fish help maintain lipid profiles.
• Prioritise lean protein. Protein influences satiety and glucose stability, especially when meals are spread throughout the day.
• Maintain regular meal timing. Consistency helps match insulin action with food intake.

Daily Food Guide

1. Carbohydrates 4555% of total calories

Choose complex, fiberrich sources:

• Wholegrain breads, pasta, couscous, barley, quinoa.
• Legumes (lentils, chickpeas, beans) excellent for both carbs and protein.
• Fruits fresh or frozen, preferably whole rather than juice.
• Vegetables especially nonstarchy types like leafy greens, tomatoes, peppers, zucchini.

Count carbohydrate portions using standard diabetes counting methods (e.g., 1carbunit 15g carbs).

2. Fats 3035% of total calories

Focus on unsaturated fats:

• Extravirgin olive oil use for dressings, cooking, and drizzling.
• Nut spreads (e.g., almond, peanut) watch portion size (1Tbsp 90kcal).
• Seeds (chia, flax, sunflower) add to yogurt or smoothies.
• Fish at least two servings per week, including oily varieties like salmon, sardines, or mackerel.

Limit saturated fat (<10% of calories) and avoid trans fats.

3. Protein 1520% of total calories

Good sources include:

• Poultry, lean cuts of pork or beef.
• Legumes and pulses (also provide carbs).
• Lowfat dairy (Greek yogurt, cheese in moderation).
• Eggs 12 per day, depending on overall cholesterol intake.

Sample Meal Plan (1650kcal)

Adjust portion sizes to match individual caloric needs, activity level, and insulin regimen.

Practical Tips for Families

• Meal planning. Involve the child in selecting Mediterranean recipes; visual portion guides help with carb counting.
• Cooking methods. Grill, bake, or steam instead of frying. Use herbs (basil, oregano, rosemary) for flavor without extra salt.
• Smart snacking. Keep fresh fruit, raw veggies, nut packs, and lowfat dairy reachable.
• Hydration. Water and unsweetened teas should be the primary drinks; limit sugary sodas and fruit drinks.
• Physical activity. Pair meals with regular exercise; adjust insulin as needed and test glucose before and after activity.

Monitoring & Adjustments

Even with a structured diet, blood glucose responses vary. Encourage regular selfmonitoring (or continuous glucose monitoring) and maintain open communication with the diabetes care team. Typical areas for review include:

• Timing of insulin relative to meals (premeal bolus 1520min before eating).
• Effect of highfat meals on delayed glucose rise; consider using extendedbolus options if available.
• Growth spurtscaloric needs may increase rapidly during puberty.
• Psychosocial factorspeer influence, school meals, and food preferences.

References (selected)

1. American Diabetes Association. Standards of Medical Care in Diabetes2024.
2. European Society for Paediatric Diabetes. Nutrition guidelines for children with T1D, 2023.
3. MartnezGonzlez MA. etal. Mediterranean diet and health: a comprehensive review. Nutrients 2022.
4. Giles, C. etal. LowGI diets in youth with type1 diabetes: a systematic review. Diabetes Care 2021.