AAP Issues Low-Carb Diet Recommendations for Pediatric Diabetes

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Safety concerns to consider for youth with diabetes who are restricting carbohydrates include growth deceleration, poor bone health.

HealthDay News — In a clinical report issued by the American Academy of Pediatrics and published online September 18 in Pediatrics, recommendations are presented for use of low-carbohydrate diets in children with type 1 diabetes, prediabetes, and type 2 diabetes.

Anna Neyman, MD, and Tamara S. Hannon, MD, from the Indiana University School of Medicine in Indianapolis, developed practical recommendations for pediatricians regarding use of low-carbohydrate diets in patients, including those with type 1 diabetes and those with obesity, prediabetes, and type 2 diabetes.

The authors note there are safety concerns to consider for youth with diabetes who are restricting carbohydrates, including growth deceleration, poor bone health, nutritional ketosis that cannot be distinguished from ketosis resulting from insulin deficiency, and disordered eating behaviors. Low-carbohydrate diets (<26% energy) and very low-carbohydrate (20 to 50g) diets are only recommended for children with type 1 diabetes under close supervision of a diabetes care team. For prevention and treatment of prediabetes and type 2 diabetes, reducing nutrient-poor carbohydrate intake by minimizing consumption of processed foods with high amounts of refined grains and added sugars is recommended. In children and adolescents, eliminating sugary beverages and juices significantly improves blood glucose and weight management. Dietary restriction of any kind has physical, metabolic, and psychological consequences, including risk for disordered eating, and poses additional risk for those with diabetes. A reduced-energy diet is most important for achieving weight loss among those for whom weight loss is medically indicated, irrespective of carbohydrate content.

“This statement is not about restrictive diets — it is about providing evidence to clinicians so they can support parents and families in making informed decisions,” Hannon said in a statement.

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