Friday, September 22, 2023

Pediatricians say children with diabetes or prediabetes should not follow a low-carb diet

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Experts say vegetables are part of a healthy diet for children. pinstock/gettyimages
  • A leading group of pediatricians warns against low-carbohydrate diets for children with diabetes or prediabetes.
  • They say these diets could harm children’s natural growth and development and should only be practiced under professional supervision.
  • Instead of following a low-carb diet, they recommend that children who need help managing their weight or blood sugar limit carbohydrates from sugar, processed foods, and sugary drinks.

Low-carbohydrate and ketogenic diets are popular among many people in the United States and, in some cases, may be helpful in managing type 2 diabetes or prediabetes in adults.

However, doctors and parents should avoid these diets in children with type 1 diabetes, type 2 diabetes, or prediabetes, according to a new clinical report from the American Academy of Pediatrics (AAP).

The report states that children should generally get between 45 and 65 percent of their daily calories from carbohydrates, while low-carbohydrate diets limit this to less than 26 percent of total calories from carbohydrates. Very low-carb diets and ketogenic diets limit this further: very low-carb diets require 20 to 50 grams of carbohydrates per day and ketogenic diets require less than 20 grams.

Although these diets may benefit adults, in practical terms there is little research supporting the safety and effectiveness of low-carbohydrate diets for children and, therefore, no clinical guidelines exist on restricting dietary carbohydrate intake, it says. the AAP report.

“Despite the growing popularity of low-carbohydrate and ketogenic diets to manage diabetes in adults, there are safety issues to consider for younger diabetics who limit their carbohydrate intake to control their weight and/or sugar levels. in blood,” write the authors of the article. report. “These include slow growth, nutritional deficiencies, poor bone health, nutritional ketosis that is indistinguishable from ketosis resulting from insulin deficiency, and disordered eating behaviors. »

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“Children should not be placed on a low-carb or ketogenic diet without adequate monitoring or monitoring by health professionals,” said Tok-Hui Yeap, RD, an Oregon-based pediatric nutrition specialist. Medical news today. “Updating guidelines on carbohydrate requirements for youth with type 1 diabetes, type 2 diabetes, prediabetes, and obesity will standardize practical recommendations from pediatricians and registered dietitians to guide a robust, evidence-based treatment plan. »

The report notes that there could be some cases where a low-carbohydrate approach could be adopted, but only under the close supervision of a diabetes care team.

“This statement is not about restrictive diets, it’s about providing evidence to doctors so they can help parents and families make informed decisions,” said Dr. Tamara Hannon, FAAP, professor of pediatrics at the University of Indiana and co-author of the study. report, she said in a news release. “Be sure to ask your pediatrician, who knows you best and can guide you on a healthy diet. »

Low carb Diets could have harmful psychological effects.

Beyond the technical aspects of a low-carb diet, experts say parents and doctors should be careful with these diets because they could have long-term effects on how children feel about food.

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“Balance, moderation and variety are the keys to good nutrition and overall good health. “One of the main disadvantages of a low-carb diet for children is the potential for children to develop an unhealthy psychological relationship with food,” said Dr. Christina Johns, pediatric emergency physician and senior medical advisor at PM Pediatric Care. . Medical news today. “For example, a child who faces a strict limitation on a type of food might crave it more and try to consume it secretly, which could lead to overconsumption and feelings of guilt. Carbohydrates are not “bad” per se; In fact, they are an important part of a balanced diet and are essential for cellular metabolism.

“I’ve met teens and children who were on low-carb diets,” said Dani Lebovitz, MS, RDN, CDCES, a Tennessee-based food and nutrition education expert and founder of Kid Food Explorers.

“In many cases, these diets, although well-intentioned, have resulted in more harm than good,” he said. Medical news today. “Many had problems with constipation, lack of energy, fear of food and embarrassment. Following a restrictive diet also presented psychosocial problems associated with stigma and peer pressure.

Instead of low-carb diets, parents and educators should strive to take a more education-based approach, said Rachael Richardson, a registered dietitian and nutritionist and founder of Nutrolution.

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“The main nutrition concept that preschoolers could and should learn is the distinction between “real” and “fake” foods, in addition to being shown how foods grow and being exposed to parents who model healthy eating,” she said. . saying Medical news today. “As they reach school age, learning the fundamentals of growing food, cooking and what is necessary for health are extremely important topics that all high school students should have the opportunity to master if we want to reduce the prevalence of diabetes and diabetes. other chronic diseases that overwhelm our health system.

Maintain healthy carbs and focus on your lifestyle

Instead of focusing on low-carb diets, the AAP recommends that parents help their children eliminate sugary drinks and juices, as well as processed foods that contain high amounts of refined grains and processed sugars.

Both can help young people with diabetes or prediabetes improve their blood sugar levels and lose weight.

“Balance and variety are very important when it comes to nutrition,” Johns said. “Ensuring children eat a variety of foods, consuming a mix of protein, carbohydrates, healthy fats and fibre, helps them develop good eating habits throughout their lives. Avoiding processed and bleached carbs is an effective way to eat “good” carbs: whole grains, whole wheat, brown rice, and plant-based alternatives are great options.

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