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From New York, USA:

There is a person on America OnLine saying that Dr. Bernstein's low-carbohydrate diet is okay for young children. I have been told that children need the carbohydrates for regular growth and that too tight of control can cause learning disabilities. My son is 5 1/2, his blood sugars are great and his last A1c was 7.5%. I hate to see parents try to do the low-carb diet and hurt their children's growth. Please let me know your opinion. Thank you!


I agree with you. Children need calories to grow and about 50% of them should come from carbohydrate. When you think about it, if we are replacing someone's insulin, the issue is matching the insulin with the carbohydrate, so the amount of carbohydrate to promote growth is the determining factor.

Calories must come from carbohydrate, protein and fat. When one becomes restricted and imbalance of other nutrients must occur to provide calories. In the case of diabetes, high protein is controversial because of the long term effect on kidneys and fat is controversial because of cardiovascular problems. And last and probably most important is the fact that children need to feel they are doing mostly the same things as other children of their age. To make a diet so restrictive that it does not allow the child to have normal foods does more to defeat the long range goal of keeping kids on track than we can probably imagine. The control your son has is commendable and it sounds like you have a very realistic view of things at your house.


Additional comment from Dr. Robertson

I don't approve of a low carbohydrate diet for anyone being treated with insulin.

I don't want to get into a debate about carbohydrate counting but children certainly need calories for growth and general health whether they have diabetes or not. In the diabetes world dietitians have been moving away from concentrating purely on carbohydrate because long term health depends on the correct balance with fat, fibre and protein as well as vitamins and minerals. Very few children with diabetes need to be on a "diet" for weight reduction but those who do usually reduce their calories by restricting fat intake rather than carbohydrate - it's actually quite difficult to get up to the 55% carbohydrate recommendation. I suppose that the point of my rambling is that any major adjustments to the diet of a child with diabetes should be carried out under the supervision of a suitably qualified paediatric dietitian.


Original posting 27 Nov 97
Additional comment added on 10 Dec 97


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