Table 1 —

Dietary advice given to subjects randomized to the CHOx or low-GI diet at entry to the study

CHOx study diet*Low-GI study diet§
CarbohydrateMeasured in 15-g complex CHO quantities and counted as either ‘half’ or ‘full’ exchangesEat regular meals and snacks based on preferred serving sizes of CHO foods to satisfy appetite
A serving is suggested to be the quantity of CHO food that fits into the child’s hand (which will vary between individuals)
RecommendationsBased on quantitative CHO intake assuming all complex CHO foods affect the blood sugar level in the same wayBased on qualitative CHO intake using principles of the healthy food pyramid with low GI emphasis, aiming for minimum of one low-GI food per meal per day
PrescriptionSet number of exchanges for each meal and snackNil prescription given and guide given to number of servings at meals/snacks to ensure appropriate CHO distribution and consistency, but no specific quantity defined
Protein/fat foodsNot measured but eat in moderationNot measured but eat in moderation
Choose low fat sources where appropriateChoose low fat sources where appropriate
Not counted as part of exchange prescription unless in pastry/battered/ crumbedNot counted as a serving unless in pastry/battered/ crumbed
Low-CHO foods (most vegetables)Identify low-CHO food sources, eaten in conjunction with correct exchanges or when hungry as “free” foodsIdentify low-CHO food sources, eaten as part of a balanced diet
Diet foods (artificially sweetened)Use strongly encouraged whenever a diet alternative was availableUse strongly discouraged with preference for use of sugar-sweetened products in moderation (only exception to this being diet drinks)
SugarUse limited to treatment of hypoglycemia episodes exercise, or special occasions onlyUse in moderation in combination with mixed meals (1.5–2.5 tbsp per day)
Literature providedExtensive food lists that quantified all foods/ingredients into 15-g CHO measures*Basic booklet including list of low-GI food sources§
Low-GI foods listed, but no actual GI values provided
AppetiteEat only free foods/low-CHO foods if hungry between meals/snacksEat extra CHO foods to appetite, particularly low GI foods
Recipe modificationList of diabetes cookbooks recommendedNo specific diabetes cookbook recommended
Sugar to be substituted with artificial sweetenerEncouraged to modify existing recipes and moderate use of sugar
Shown how to calculate individual recipe ingredients to determine exchange value of baked productIncorporate low-GI ingredients where appropriate
Label readingFocus on dividing total grams CHO in nutrition panel by 15 to determine exchange value and limiting/avoiding products high in sugarsFocus on ingredient list and sources of sugars, fats, fiber, and low-GI ingredients and the order in which they appear on the label
Activity/exerciseEat one extra exchange per hour of strenuous activityEat one extra serve of CHO food per hour of strenuous activity
  • Literature provided to reinforce advice:

  • *

    * Traffic Light Guide To Eating. Gilbertson H, Ed. Melbourne, Australia, Nutrition and Dietetic Department, Royal Children’s Hospital, 1992;

  • The A to Z Carbohydrate Exchange Booklet for Diabetes. Gilbertson, H, Ed. Melbourne, Australia, Nutrition and Dietetic Department, Royal Children’s Hospital, 1993;

  • Modern Living With Diabetes: For All Ages. 2nd ed. Court JM, Ed. Melbourne, Australia, Diabetes Australia Victoria, 1991;

  • §

    § Diabetes: A Guide to Eating. Gilbertson H, Ed. Melbourne, Australia, Department of Nutrition and Food Services, Royal Children’s Hospital, 1996;

  • The GI Factor: The Glucose Revolution. Brand-Miller J, Foster-Powell K, Colagiuru S, Eds. Sydney, Australia, Hodder and Stoughton, 1998.