One in 600 children has type 1 diabetes—a number that’s growing at nearly 3 percent each year, according to a decade-long study by the World Health Organization. The rise in type 2 diabetes is even more alarming. Once limited to adults, the disease now affects almost 40,000 kids, blamed in large part on the fact that nearly one in three American kids is overweight or obese, according to the Journal of the American Medical Association. As a result, more parents are counting carbohydrates as they plan family meals and are looking for school lunch and snack ideas that are nutritious, low in carbs and appealing to an often-finicky eater.
“I try to buy organic as much as possible, I try not to do processed foods and we try to do meat and veggies at night,” says Debbie Frei of Denver, whose 7-year-old son, Aidan, was diagnosed with type 1 diabetes in 2006. “If there was somebody [in the stores] that could help us do more meal planning, that would be great. There’s only so much broccoli and salad you can eat.”
To help parents, retailers can jump in by understanding more about diabetes. The easiest part is that diabetics are typically told to eat a balanced diet, just like everyone else. But experts suggest store owners also provide detailed nutritional information for diabetic-friendly foods, healthy meal ideas and links to educational resources.
Type 1 and 2 diabetes have different causes, but in both cases diabetics have a genetic predisposition to the disease and have experienced something in their environment to trigger it, according to the American Diabetes Association.
Type 1, once called juvenile diabetes, usually is diagnosed during childhood. It starts when the pancreas stops producing insulin—the hormone that converts sugar, starches and other foods into energy, according to the ADA.
At least 90 percent of diabetics are type 2, the ADA says. Their bodies either do not produce enough insulin or their cells become resistant to insulin. Among type 2 diabetics, 90 percent are overweight, according to The Obesity Society. Being overweight makes it more difficult for the body to control blood sugar. Some type 2 diabetics can manage or prevent their disease through a healthy diet, exercise and maintaining a healthy weight, according to the Mayo Clinic. Others need medication.
In a 2006 article published in the Archives of Pediatrics and Adolescent Medicine, researchers estimated that 39,000 U.S. adolescents had type 2 diabetes. Almost 2.8 million had “impaired fasting glucose levels,” putting them at high risk for developing type 2 diabetes.
The non-diet of diabetics
Most diabetics are told to eat a variety of healthy foods—vegetables, fruits, whole grains, lean meats and other proteins like beans, nuts and low-fat dairy. The tricky part, especially for parents of type 1 kids, is that every meal is a math equation. The amount of carbohydrates in a food indicates how much insulin a diabetic needs to regulate his or her blood sugar throughout the day.
What’s frustrating, says Suzanne Hunter of Cross Roads, Texas, is that many packaged snacks contain more than one serving, which makes it more difficult to track carbs for her 6-year-old son, Kieran, who was diagnosed with type 1 diabetes last year. “It would be great to be able to get healthy low-carb, prepackaged foods in individual serving sizes, besides crackers and cookies,” which tend to be high in carbs, she says.
Health professionals agree that diabetics should avoid fruit juices and sodas and limit processed foods, which are usually higher in carbohydrates. High-fiber foods can help delay sugar absorption, which may help control blood sugar levels. However, there’s a growing debate about how much and what types of carbohydrates a diabetic should consume.
Kristy Fassler, ND, of Portsmouth, N.H., suggests her diabetic patients get most of their carbs from vegetables and fruit, and avoid or at least limit grains, particularly wheat. A growing body of research backs that up. A study led by Tony Hansson, MD, at Sweden’s Uppsala University, which was presented at the international gastroenterology conference Gastro 2009, shows that one in 10 kids with type 1 diabetes also has celiac disease, which requires them to avoid gluten from wheat, rye and barley flours.
“Whether it’s a pediatric patient or an adult, I recommend a low-glycemic diet all the way around,” adds Fassler. The glycemic index ranks many foods based on how much they affect blood glucose levels. Some experts say that eating healthy, lower-GI foods may help type 2 diabetics lose weight or maintain a healthy weight.
Reaching diabetic customers
Nearly five years after her son was diagnosed with diabetes, Frei can rattle off carb counts for many foods. Still, with so many fruits and vegetables to choose from, she would love to see a poster in the produce section listing glycemic and carbohydrate values. Recipe ideas would also be helpful, she says, noting that “if you didn’t know how to cook and you were diagnosed with diabetes, it would be really challenging.” Frei also suggests retailers do more cooking demonstrations: “What if you had someone not only [sampling foods] in the store, but someone in the vegetable section cooking a meal—someone to say ‘let me show you how to cook turnips kids will eat?’”
Posting recipes in the store and online is an easy way to help shoppers plan meals, says marketing consultant Neil Reay of Provo, Utah-based Impact Consulting. He notes that most families make the same 20 or so dinners over and over, so “every time you give them a new recipe, that’s a 5 percent increase in their choices.” He suggests printing off recipes from reputable websites such as diabetes.org (the ADA site), mayoclinic.com, naturaldiabetics.com and diabetic-recipes.com.
Since diabetics are eating across a variety of food groups, special sections in stores don’t make much sense, says Ximena Jimenez, RD, of Miami, whose specialties include diabetes and the Latino population. Plus, doing so would make diabetic kids feel different, she says.
Retailers need only send kids one simple message, Jimenez says: “Healthy foods taste good and are good for you.”
While it would be ideal for stores to have health experts on hand to advise parents about diabetes and other conditions, that’s not always realistic. Still, employees can provide these shoppers with a high level of service.
“Maybe you have access to a laptop in the store,” Reay says. “You can say ‘look at this website; here are some recipes.’ You’re giving them service without prescribing. It creates community. It says ‘you care about me’ and ‘people like me shop here.’”
A store’s website or Facebook page are great places to share links to information on diabetes and other health topics, Reay adds. They are also good places to create forums for specific demographics, like parents, who can meet and share health and nutrition information with other parents.
Five things retailers should know about diabetes
- The medical and nutrition community doesn’t entirely agree on diet recommendations for diabetics, including the relative importance of limiting grains, reducing all carbs and using the glycemic index to help make healthy food choices.
- High-fiber foods may help control blood glucose levels.
- Diabetics are better off with lower-salt versions of canned and packaged soups and vegetables.
- Food packages boasting “low sugar,” “sugar free” or “diabetic friendly” labels can be misleading. Total carbs per serving may be high even when sugar content is low.
- Diabetics can eat sugar and sweets in moderation.
Education doubles as promotion
Solvang, Calif.-based New Frontiers Natural Marketplace, which has five stores across California and Arizona, reaches out to shoppers in a variety of ways to educate them about food and health—including diabetes-related topics.
“Each month we have a theme, and we try to make it the focal point for our education,” says Marketing Director Ron Colone.
Here are a few ways his stores educate customers:
- Running articles in their weekly sales flyers, such as “The role of fiber in controlling blood glucose levels,” then placing the flyers in relevant areas of the store.
- Flagging supplements that, for instance, “support insulin levels.”
- Holding weekly seminars and tastings in the store and inviting health experts to speak on topics such as “Controlling and reversing type 2 diabetes” and “Low-glycemic foods.”