Everyone loves food - food tastes good, food can be fun and food can make us feel good! But food's also important for lots of other reasons too, like giving us important vitamins and minerals for our body to work properly, energy to do the things we like to do and making sure that we grow like we should.

Forget the fad diets and latest food craze, healthy eating is pretty straight forward. It's as easy as choosing foods from the "eat most" section of the healthy food pyramid everyday, with smaller amounts of "eat moderately" foods each day. The "eat only a little" foods can be enjoyed for treats or on special occasions, like parties.


To be healthy you need to eat a variety of food every day
This food pyramid is a good guide to making good choices

Healthy eating for teenagers with diabetes is the same as what's recommended for all teenagers. You don't need special foods, so your friends, brothers and sisters should all be eating the same healthy foods as you, everyday!

The difference is, when you've got diabetes, there's a few extra things that you need to think about, like.

Carbs, proteins and fats
Food's made up of three main fuels - carbohydrates, proteins and fats. They all do something different in the body, but they're all important.

Everyone needs the right amounts of carbohydrates, proteins and fats each day for good health.

Carbohydrates
Carbohydrate foods give your body energy. When you eat carbohydrate foods, they break down into sugar or glucose in your body. With the help of insulin, your body uses this glucose for energy.

Carbohydrate foods are things like:

• Bread and bread rolls
  
• Breakfast cereals
  
• Dairy and soy milk, yoghurt, ice cream and custard
  
• Fruit and fruit juice
  
• Starchy vegetables like potato, sweet potato and corn
  
• Rice, pasta and noodles
  
• Baked beans and lentils
  
• Snack foods like biscuits, chips, muesli bars
  
• Sugars and sugary foods
  
• Takeaway foods like pizza, fries and burgers

Carbohydrates & Diabetes

• To look after blood glucose levels (BGLs) it's important to eat carbohydrate foods at each meal and snack and try to balance these from day to day.
  
• Carbohydrate exchanges can help - exchanges (or serves) tell you how much carbohydrate is in different foods. Counting carbohydrate exchanges can help you balance the carbohydrate foods that you eat with your activity level and insulin dose.
  
• The type of carbohydrate foods that you eat is also important. The best carbohydrates to choose every day are things like fruit, bread, cereals, milk, yoghurt, starchy vegetables, rice and pasta.
  
• Sugars and sugary foods are not the best carbohydrates to choose because they put a lot of glucose in to the blood stream and may cause high BGLs.
  
• Some carbohydrate foods give you longer lasting energy. These foods are called low glycemic index foods and include things like grainy breads, raisin bread, fruit, baked beans, pasta, noodles, yoghurt and milk. These carbohydrates are good when you need longer lasting energy, like before sport. They are also a great choice before bed to help stop your BGLs dropping low overnight.

Proteins
Protein foods are important for growth and development. Protein foods are things like:

• Meat
  
• Fish
  
• Chicken
  
• Eggs
  
• Nuts
  
• Cheese

You need about 1-2 serves of protein foods each day for good health. One serve is about how much fits into the palm of your hand. Most protein foods don't breakdown into glucose in your body, so they don't raise BGLs. Unlike carbohydrate foods, you don't need to count protein foods or eat these at each meal and snack.

Fats
Fats are important for good health, but you only need a small amount everyday.
Fats are found in lots of different foods, especially:

• Butter
  
• Margarine
  
• Oil
  
• Cream

Some fats are better for you than others. The best types to choose are the vegetable fats like poly or mono unsaturated margarine and oil. Fats don't raise BGLs, but too much fat can lead to health problems like being overweight or having high cholesterol (a type of fat in the blood). Try not to eat too much of any type of fat.

It's important for everyone to make healthy food choices. When you have diabetes there's some extra stuff you also need to think about to help look after diabetes and keep you healthy. It's important to:

Eat your meals and snacks at the right time
Depending on the insulin you're on, you might need to eat every 3 hours or so. If you forget to eat, skip meals or leave it too long until you eat, you might have a hypo (low BGL).

Eat carbohydrate foods at each meal and snack
You need to make sure that you eat some carbohydrate foods at breakfast, lunch, dinner and snacks like recess, afternoon tea and supper. If you've been told to follow carbohydrate exchanges, try and eat around the same number of exchanges at meals and snacks each day.

Choose foods low in fat
Too much fat can be bad for your health. Try to choose low fat milk, yoghurt and cheese. Watch out for foods that are high in added fats, like snack foods - crisps, biscuits, chocolates, cakes, donuts, as well as takeaways, fatty meats and fried foods.

Watch out for foods that are high in sugar
Foods high in sugar like regular soft drinks, cordials and lollies can cause BGLs to go too high. Make sure that you use diet / low joule soft drinks and cordials and try to keep other high sugar foods for special occasions. Remember that foods high in sugar can be used to treat a hypo.

Always carry hypo foods
Sometimes your BGLs can drop too low and you might have a hypo. To treat a hypo, you need to quickly eat or drink something sweet and then eat something else straight away to stop the hypo from coming back. Make sure that you always have hypo foods like juice or jellybeans with you, plus follow up food like plain biscuits or a muesli bar to stop you from dropping low again.

To be healthy, it's important to make healthy food choices from day to day. This means having a healthy lunchbox, having healthy snacks and checking out the best choices in the supermarket.

Food at School

A healthy lunchbox.
It's important that you eat the right amounts of food at recess and lunch to help keep your BGLs mostly within the normal range. Remember if you skip recess or lunch or you might have a hypo.

Try some of these healthy lunchbox ideas:

• Sandwiches
  
  • try different types of breads like rolls, grain bread, Turkish bread, bagels, lavash or pita bread
    
  • use fillings like salad, low fat cheese, vegemite, ham, chicken, tuna, salmon, egg, baked beans, spaghetti or banana
    
• Pasta, potato or rice salad
  
• Fresh pieces of fruit eg. apples, pears, mandarins, oranges
  
• Chopped fruit eg. rockmelon, pineapple
  
• Fruit in zip lock bags eg. grapes, cherries
  
• Fruit snack packs
  
• Crispbreads, rice cakes or corn thins
  
• Pikelets, scones or low fat muffins
  
• Low fat yoghurt or dairy desserts
  
• Dried fruit boxes eg. sultanas, apricots
  
• Low fat milk tetra pack
  
• Rice crackers or rice crisps

To keep lunch cool, add a frozen water bottle to your lunchbox or use a cool pack!

At the canteen.
Most schools are now swapping over to healthy canteens. That means that a lot of the stuff is lower in fat, salt and sugar than it used to be. Look for healthy carbohydrate choices like sandwiches or rolls, corn on the cob, reduced fat mini pizzas, pasta, soup or rice dishes. When it comes to drinks the best choices are diet soft drink, water or 100% juice. It's not a great idea to eat from the canteen everyday, besides the fact that it costs a lot, it's probably not as healthy as the stuff you can bring from home.

Serious Snackin'
Depending on the insulin that you're on, you might need snacks like recess, afternoon tea and supper to keep BGLs mostly in the normal range. Try some of these snack ideas

•  Piece of fresh fruit eg. apple, pear, banana, orange
•  Chopped fruit - rockmelon, pineapple, honeydew
•  Fresh fruit salad
•  Grapes or cherries
•  Canned fruit snack pack eg. two fruits, peaches, pears, fruit salad
•  Dried fruit boxes eg. sultanas, fruit salad, sultanas and apricots
•  Low fat yoghurt
•  Low fat dairy desserts
•  Low fat custard
•  Corn on the cob
•  Pikelets or scones
•  Fruit loaf, fruit bun or hot cross buns
•  Crispbread or rice cakes with low fat toppings e.g. tomato, low fat cheese
•  Popcorn
•  Crumpets or English muffins
•  Rice crackers with low fat dip
•  Rice crisps
•  Low fat fruit bars

Checking Out the Choices
Looking at food labels when you're in the supermarket can help you find the best everyday food choices. To work out the best choices, look at the nutrition panel on the food label. This tells you things like how much carbohydrate and fat is in different products. A nutrition panel looks like this:

To make healthy food choices, compare different products and look for foods that are lowest in fat, especially saturated fat. To work out carbohydrate exchanges, look at how much total carbohydrate is in the food in the amount that you're going to eat. Remember one exchange contains 15grams of carbohydrate. So you need to divide the total carbohydrate by 15.

You can also look at the ingredient list to work out whether or not the food is a healthy choice. If fat ( eg. butter, cream, oil ) or sugar ( eg. sugar, sucrose, glucose ) are listed first or second then the product may not be a good everyday choice.

Food 4 Hypos
Hypos or low BGLs, happen when your BGL drops to less than 4. Hypos can be caused by lots of different things, like being more active than usual, not having the right balance of insulin or skipping meals. Sometimes hypos can happen for no reason at all!

To treat a hypo, quickly eat or drink something sweet like:

• 125 - 200ml fruit juice (1 small popper) or
  
• 1/3 - ½ can regular soft drink (not diet) or
  
• 3 teaspoons honey or sugar or
  
• 4 large or 7 small jelly beans

Then eat something else to stop the hypo from coming back, like:

• A piece of fruit or
  
• A slice of bread or
  
• Two plain sweet biscuits or
  
• A glass of milk
  
• If it's just before recess, lunch or a meal, eat or drink something sweet then eat your meal

Don't forget to always carry hypo foods with you and always tell an adult when you have a hypo. Make sure you don't ignore a hypo even if you're worried about what everyone else will say. No one likes to be embarrassed, but ignoring a hypo can make you feel worse and can be more embarrassing if you don't treat it.

Food 4 Sport
When you're active you usually find that you need some extra carbohydrate foods to top up your energy levels and stop you having a hypo. You might need extra carbohydrate foods before, during and after exercise. One extra carbohydrate exchange for every 30-40 minutes of exercise is a good guide. So don't forget to throw in some extra carbohydrate foods. Hypos can happen for 12-16 hours after you stop exercising, so keep an eye on your BGLs and top up your carbs if you need to. If you find that sport always drops your BGLs, talk to your diabetes team about changes you can make to your insulin dose that might help.

Try these carbohydrates before sport :

• A piece of fruit
  
• A small flavoured milk
  
• A muesli bar
  
• A fruit snack pack
  
• A crumpet or slice of raisin toast
  
• A 'fun size' chocolate bar

To top up during sport , try:

• A 100% fruit juice popper
  
• A cup of sports drink
  
• A piece of fruit eg. banana, orange

Don't forget to pack a hypo kit with hypo foods for sport.

Food on the Run
Lots of takeaway foods can be high in fat and sugar. To be healthy, it's a good idea not to eat takeaways any more than once a week. When you choose takeaways, it's important to try and make the healthiest choices, look for lower fat takeaways like:

• Lean meat or chicken salad roll / wrap
  
• Doner kebab with lots of salad
  
• Plain hamburger with lots of salad
  
• A grilled chicken burger with lots of salad
  
• Baked potato (skip the butter)
  
• Toasted sandwich
  
• Corn cob
  
• Sushi roll
  
• Vegie pizza or gourmet pizza
  
• Toasted sandwich or focaccia
  
• Small bowl of pasta with tomato based sauce
  
• Stir fried vegetables with noodles or plain rice

Take care with choosing drinks - avoid regular soft drinks as these are very high in sugar, choose diet or low joule drinks instead. If you're having juice, look for 100% fruit juice and choose a popper or small bottle.

Lots of takeaways are also very high in carbohydrate (eg. pizza, fries, smoothies). If you can, check to see if the takeaway outlet has any nutrition information available. Many of the popular fast food chains eg. McDonalds, Subway, Krispy Kreme have nutrition information brochures that tell you the amount of fat and carbohydrate in their different products. Look for foods that are lower in fat and have about the same amount of carbohydrate as you would normally eat at your meals. If you adjust your insulin depending on what you eat, use this information to make sure that you take the right amount of insulin so that your BGLs don't end up too high when you eat takeaways. Talk to your dietitian and diabetes educator about adjusting insulin around food.

Insulin pumps can be a great way to help manage your diabetes. If you decide to start on a pump you might notice that a few things about food are a little bit different.like closer counting of your carbohydrate exchanges / amounts, and more flexible meal times and amounts of food.

Why do you need to count carbohydrates?
We know that carbohydrate foods put glucose (sugar) into your blood stream for energy. The insulin you inject needs to match your carbohydrate foods (and activity) to keep BGLs mostly in the normal range. This is important whether you're on a pump or not.

When you're on a pump you can match your food and insulin more closely because every time you eat, you program the pump to give you quick acting insulin (bolus). Your diabetes team will tell you how much insulin you need to give for every carbohydrate exchange you eat. If you're not sure how much carbohydrate you're going to eat you can also give the insulin after you eat. Some pumps even let you program in how many grams of carbohydrate you've eaten and it then works out how much insulin to give.

How do you work out how much carbohydrate is in different foods?
Your dietitian can help you work out how much carbohydrate is in different foods. You might need to weigh or measure out carbohydrate foods to help you count carbohydrates. You also need to be able read food labels to work out how much carbohydrate is in different foods.

Do you need to follow set carbohydrate exchanges?
When you're on an insulin pump you don't need to eat the same number of exchanges at your meals each day. If you're not very hungry you can eat less and if you're really hungry, you can eat more. You can then give your insulin depending on how much carbohydrate you've eaten.

Do you need to eat snacks between meals?
On an insulin pump you don't need to have snacks if you don't want to, but it's important to eat regular meals to be healthy.

Does being on a pump mean you eat anything you want?
When you're on a pump, you still need to make healthy food choices. Lollies, soft drinks, crisps and chocolates are not great choices for anyone. On a pump, you should still use diet or low joule soft drinks and keep snack foods as special occasion treats.

What do you do at school when you're on a pump?
At school, you need to remember to give your insulin bolus when you eat. To do this, you need to know how much carbohydrate is in the foods that you have at recess and lunch. Knowing the amount of carbohydrate in different canteen choices is also important.

What about food for sport when you're on a pump?
When you're on an insulin pump you can still play sport. You might find that you still need some extra carbohydrate foods for energy. On a pump you can reduce your insulin before and after sport and you might not need to eat as much extra food to prevent hypos.

How do you find out more about food and pumping?
When you start on a pump your Dietitian can give you some extra healthy eating info.