Make A Healthy Plate
Catering to campers with diabetes while satisfying all diets
By Terri Nighswonger
Whether conquering a fear of heights by trying the high ropes, swimming in a lake for the first time, or tasting a new food, camp is a place for kids to learn, grow, and experience new adventures. At Camp Ho Mita Koda in Newbury, Ohio, campers do all those things, plus learn how to count carbohydrates, check their own blood sugar, and give themselves their own shot of insulin. Camp Ho Mita Koda is the oldest camp in the nation for children with diabetes.
© Can Stock Photo Inc. / Res_Art
Campers can’t eat peanut butter sandwiches all week here, but with a little help, they can enjoy good food combined with a learning experience. That’s a recipe all kids can take home.
“We have to make sure the menu is adequate for calories, carbohydrates, proteins, fat—basically their nutritional adequacy,” says Lisa Beaudis, registered dietitian and a Certified Diabetes Educator for the Diabetes Partnership of Cleveland. “You also have to make sure that it has foods the kids want to eat. If we make something that’s healthy and they’re not going to eat it, then they’re going to have the low blood sugar.”
Beaudis and Mary Ann Nicolay, a dietetic technician, registered (DTR) and health educator for the Diabetes Partnership, begin planning menus for camp sessions in January.
“It’s not something we can do in just one day. We work on these menus for probably a good two months,” Beaudis says. “We look at them and then look at them again, finding new things. We also have to make sure the foods we are choosing fit into our budget. It is a big challenge.”
It helps that the camp’s food distributor has a website with extensive nutritional analysis. An added challenge is accommodating children with celiac disease or allergies that also have to be factored into the menus.
“It’s not just eating healthy for kids with diabetes, but we also had a lot of children with other health concerns besides just diabetes. Incorporating that and trying to make a menu that would work for everyone is a challenge,” Beaudis says.
Nicolay says the access to nutritional information is the key.
“It’s got to be at our fingertips, and that’s why we use the company that we use because I can go online, or the chefs can go online and get immediate nutrition information for the product,” Nicolay says. “By having all that information on the website, we look at ingredients and make appropriate choices. That, to me, is crucial not just for kids with diabetes but kids with allergies … you’ve got to have that nutrition information.”
Keeping Costs Down
Except for certain gluten-free foods, Nicolay and Beaudis agree that the food costs they incur are not necessarily higher than average.
“I don’t think our food costs are higher because we are not buying special foods, we’re buying normal foods,” Nicolay says. “I’d rather show a child how to eat something than tell them, ‘you can’t have it.’”
They plan to reduce the costs of even those more-expensive specialty foods.
“If we had reviewed the menus a little bit better and then used different products or changed it slightly, it would be better,” Beaudis says. “One day I bought ten gluten-free burritos, and it was $50. If we had the gluten-free wrap, then we could have made them ourselves, and that would have been a lot better. I know that’s something I want to work on for next year.”
The camp doesn’t serve any soda, except for an occasional ice-cream float. Even powdered sugar-free drink mixes were eliminated for cost savings.
“We try to make sure they get in their milk every day. Between meals we used to use a lot of the powdered drink mixes so they would have a little variety, but we tried to cut back on that this year because it is so expensive. We don’t want them to have all the sugar substitutes so we made our own flavored water,” Nicolay says. “We had a big water container that we would fill. We would put sliced cucumbers in it. We’d put sliced citrus fruit or something like that. I got the cooks to use herbs and things from the garden; we played around with our own flavored waters, and it was a huge success so we will do that again next year. Plus, we were able to show the kids something they could do at home and they liked it.”
A Typical Menu
The kitchen staff incorporated several whole grains into the menu this past camp season with brown rice instead of white, whole-grain pastas, and whole-grain breads. Breakfast lean-protein options included cottage cheese, yogurt parfaits, and string cheese. Those foods helped fill the kids up without elevating their blood sugars, Beaudis says.
Often the kids wanted extra food so the nutrition staff agreed it was a good indication that they liked the food.
“Standing by the trash can is usually what I do when I go out to camp. I keep looking over to see what’s being thrown away. If I see something being tossed, then I really evaluate it. We don’t really have that issue so that’s pretty cool,” Nicolay says.
She adds, “The kids are pretty easy to please. They like chicken, pizza, calzones, mashed potatoes, and gravy to name a few.”
“We tried seafood this year. They didn’t like that,” Nicolay says. “They like things that kids like. We just have to find a way to do it in a heart-healthy, diabetes-friendly way.”
One of the meals campers really liked was mashed potato bowls. Mashed potatoes are topped with vegetables, gravy, and chicken with cheese on top. While it sounds carb-loaded, the cooks use grilled chicken and a low-carb vegetable, such as green beans instead of corn.
Independent Choices
Helping campers become independent with their diabetes is emphasized at Camp Ho Mita Koda, which includes a dry-erase board in the cafeteria line listing the foods on the menu for each meal. After each item, the carbs are listed with portion sizes.
“We won’t buy the bowl-pack cereal or the individual, ready-to-serve cereal because of the cost. We buy cereal in a big box or bag and then put it into containers, and give the kids measuring cups so they can measure out the portions. That’s part of the learning experience,” Nicolay says.
One of the campers’ favorite snacks is the PBG. It’s a graham cracker spread with peanut butter and then frozen. The concoction is used to treat low blood sugars, but the kids, counselors, and staff members love them, Beaudis says. Instead of orange juice that raises their blood sugars quickly, the PBG gives a more gradual increase in blood sugar and stabilizes them for a longer time.
Whether the campers served have diabetes or not, Nicolay recommends a complete meal that teaches kids about nutrition in a positive way.
“This year we would like to go with an overall theme of health and nutrition so that we can get messages across in easy and fun ways. I don’t know what it’s going to look like, but we always concentrate on carbs at camp, which is important for kids with diabetes, but sometimes we get so caught up in counting the carbs that we don’t look at the whole plate,” Nicolay says.
Nicolay hopes to use the “My Plate” meal-planning system that utilizes a 9-inch plate divided in half, with vegetables, ¼ protein, and ¼ starch plus fruit and milk.
“It’s kind of a fun game for kids to see how the food fits on the plate. What if you have a casserole? How do you figure that one out? So we will plan some fun things around that,” she says.
With a kitchen staff that is capable of cooking from scratch, they plan to use much more home-cooking, getting away from pre-prepared, heat-and-serve foods.
“I think what’s exciting for me for next year is to come up with a nutrition theme that’s not going to shove it down kids’ throats, but it’s going to provide some ideas for decoration, some accidental learning. Something fun,” Nicolay says.
Terri Nighswonger is a communications specialist for Diabetes Partnership of Cleveland. Camp Ho Mita Koda is a program of the partnership. She can be reached at tnighswonger@diabetespartnership.org . For information about Camp Ho Mita Koda, visit www.camphomitakoda.org .
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A Sample Menu
Breakfast
(Provide a heart-healthy protein food to keep blood sugars from fluctuating up and down, providing some stability.)
Yogurt
String cheese
Portioned serving of peanuts
Occasional eggs or egg sandwiches
A selection of cereal, fruit, toast, bagels, and English muffins
On alternate days, offer something special, like pancakes or egg sandwiches or waffles.
Snacks
Fruit (fresh or canned, water-packed)
Baked snack bags of pretzels, chips, or 100-calorie snack packs
PBGs (a graham cracker spread with peanut butter and frozen)
Lunch/Dinner
“Free foods” (vegetables) that have little effect on blood sugar
Grilled chicken
Potatoes
Carrots and peas
Whole-grain dinner roll
Fruit or sugar-free pudding
Salad with low-fat dressing
A substitute is generally a roasted lunch-meat sandwich or a peanut butter and jelly sandwich.
Dessert
Portion-controlled ice cream, cookies, s’mores (from 15 to 17 carbs)
What To Limit Or Avoid Completely
Soda
Fried foods
Breaded foods
Sugar substitutes
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By The Numbers—A Glimpse At Camp Ho Mita Koda
Campers enrolled in 2013: 157
Cost for food and services for camp: $17,500
People served at meals: 35 staff; 25 to 55 children, depending on the session
Staff
3 kitchen staff
4 dietetic interns
2 dialysis patient-care nutritional staff
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Parent Responses
“She told me her favorite thing at camp was the food..”
“Amazing food.”
“He came home and told us the food was amazing. Could I have some of the recipes so I can make his favorite camp foods at home?”