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by Scheinberg D

Carbohydrate-Counting Diet

What It Is

Carbohydrate (carb) counting is a way to keep track of the number of carbs you eat at each meal. Carbs from your food get digested and absorbed as a sugar known as glucose. Counting them helps you to be aware of how food will affect your blood glucose. This is important if you need to manage your blood sugar levels.

How It Helps

Carb counting is helpful if you take insulin shots. It helps you to balance food intake with insulin. The more carbs you eat, the higher your blood sugar will be, and the more insulin you will need. Always ask your doctor before adjusting insulin doses on your own.

The Basics

When you eat carbs, your body turns them into glucose. The foods that raise blood glucose the most are the ones that have carbs. Foods like starches, milk, fruit, and sweets are carbs.
Carbs can be simple or complex:
  • Simple carbs, or sugars, are table sugar, honey, high fructose corn syrup, and the sugars found in milk and fruit. These raise blood sugar right away.
  • Complex carbs, or starches, are whole grains, starchy veggies, and legumes.
Types of Carb Healthy Choices Foods to Limit or Avoid
Simple
  • Low-fat milk and milk products
  • Fruits
  • Table sugar
  • High fructose corn syrup—This is found in soda and juice drinks. It is often added to processed foods. Read the food label.
  • Honey
  • Foods high in added sugars like candy, cookies, or ice cream.
Complex
  • Whole grains
  • Starchy veggies
  • Beans
  • Lentils
Refined starches like white flour, white flour products, and white rice.

How Much Is One Serving of Carbs?

One carb serving is equal to 15 grams of carbs. This is about the amount of carbs in one slice of bread, ¾ cup dry, unsweetened cereal, ½ cup of pasta, 1 cup of milk, or 1 small piece of fresh fruit.
Since they have similar effects on your blood sugar, they can also be exchanged. This is because these foods are generally considered carb servings. You may trade one starch serving for 1 fruit or milk serving.
This table lists foods that have about 15 grams of carbs per serving.
Group Serving Size and Type
Fruits
  • 1 small piece of fresh fruit
  • 1/2 cup of canned or frozen fruit
  • 4 ounces of juice
Starchy veggies like potatoes, sweet potatoes, corn, green peas, or green lima beans
  • 1/2 cup mashed potatoes
  • 1/4 of a large baked potato
  • 1/4 cup of peas or beans
Grains
  • 1 slice of bread
  • 3/4 cup unsweetened cereal
  • 1/4 cup granola
  • 1/3 cup rice
  • 1/3 bagel
  • 3 cups popcorn
Protein
  • 1/2 cup beans
  • 6 chicken nuggets
Dairy
  • 1 cup milk
  • 2/3 cup of plain fat-free yogurt
  • 1/2 cup ice cream
Other
1 medium sugar cookie
Meats and fats contain little or no carbs, while nonstarchy veggies contain only five grams per serving. One serving equals one cup raw veggies or ½ cup cooked. Examples of nonstarchy veggies are:
  • Broccoli
  • Dark green leafy lettuce or spinach
  • Artichoke hearts
  • Asparagus
  • Celery
  • Cucumbers
  • Eggplant
Many sources give carb count lists. In addition, most packaged foods have labels with the amount.

How Much Carb Can I Eat?

Most people with diabetes should eat between 45%-65% of their calories as carbs. The balance can come from fat and protein.
There are four calories in every gram of carb. So, for example, if you are on a 2,000-calorie diet with 50% of your calories coming from carbs, you can have a total of 16 servings of carbs per day.
Calculating Carb Servings
(2,000 Calorie Diet)
50% of calories from carbs = 1,000 calories
1,000 calories divided by 4 calories per gram of carb= 250 grams
250 grams divided by 15 grams carb per serving = 16.66 servings
You should space out your carbohydrate servings into at least three meals per day with a snack in between. This will keep your blood sugar steady. Plus, the more fiber the source of carbs contains, the better the effect on your blood sugar.
This table shows different ways that these 16 carb servings could be distributed. Keep in mind the more evenly spaced they are, the better:
Breakfast
4 4 2 3 4 3 0
AM Snack
0 2 2 2 2 1 3
Lunch
5 4 4 3 5 4 3
PM Snack
0 2 2 2 2 2 3
Dinner
5 4 4 4 3 4 4
Evening Snack
2 0 2 2 0 2 3
TOTAL CARBS
16 16 16 16 16 16 16

Meal Planning

A dietitian can help you learn how to count carbs and come up with a meal plan that is right for you. The dietitian will look at things like how well you are managing your diabetes, how active you are, how much you weigh, and how old you are.

What Should I Think About When Meal Planning?

Count Your Carbs
Learn which types of foods have carbs and the amount per serving. There are many online tools to help you count carbs and plan meals.
When you shop, remember to read food labels. This will tell you the portion size and the total carb amount.
To help you count, use measuring cups and spoons, as well as a food scale. An apple weighing 4 ounces has about 15 grams of carbs.
Use a worksheet to keep track of your meals, drinks, and snacks. Share this information with your dietitian so your progress can be checked. Carbohydrate counting programs can also help you stick to your meal plan.
Be Aware of Foods That Are Carb-Free
Not all foods contain carbs! A six ounce serving of ground beef doesn't have carbs, but has over 500 calories. One teaspoon of corn oil also doesn't have carbs, but has 40 calories.
With this in mind, choose your proteins and fats wisely. If you eat them too much, you may go over your target calorie level and gain weight. Foods that are high in fat and cholesterol should also be limited to lower your risk of heart disease.
Don’t Forget About Fiber
Fiber is a carb. But, because the body can't break it down, it does not affect blood sugar. If you eat many high-fiber foods, you may want to talk to a dietitian about label reading to learn how to subtract the dietary fiber grams from the total carb grams. This gives you a more accurate estimate of the carbs that will affect your blood sugar.
Make Healthy Choices
Eat a variety of healthy foods everyday by choosing:
The US Department of Agriculture’s Choose My Plate website offers more tips, like:
  • Watch your portion sizes!
  • Fill half your plate with fruits and veggies.
  • Make half your grains whole grains.
  • Drink fat-free or low-fat (1%) milk.
  • Be aware of the sodium amounts, especially in soup, bread, and frozen foods. Choose lower sodium products.
  • Instead of drinking sugary drinks, have plain water instead.

Sample Meal

Are you wondering what it would be like to eat a carb-friendly dinner? Here is just one example, but keep in mind that a dietitian can help make a meal plan just for you.
Food
Carbs
Small raw apple
15
Chicken, baked, 6 ounces
0
Pasta, 1/2 cup
18
Zucchini, cooked 1/2 cup
5
Bread, 1 slice
15
Non-fat milk, 1 cup
15
Total Amount of Carbs
68

RESOURCES

American Diabetes Association
http://www.diabetes.org
Choose My Plate—US Department of Agriculture
http://www.choosemyplate.gov

CANADIAN RESOURCES

Canadian Diabetes Association
http://www.diabetes.ca
Dietitians of Canada
http://www.dietitians.ca

References

Carbohydrate counting with chronic kidney disease. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/carbcount.cfm. Accessed October 1, 2018.
Dietary considerations for patients with type 2 diabetes. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T270045/Dietary-considerations-for-patients-with-type-2-diabetes. Updated December 20, 2017. Accessed October 1, 2018.
Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at: http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed October 1, 2018.
Understanding carbohydrates. American Diabetes Association website. Available at: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates. Accessed October 1, 2018.

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