Carbohydrate-Counting Dietby Maria Adams, MS, MPH, RD and Rebecca J. Stahl, MA What Is Carbohydrate Counting?Carbohydrate counting is a method of keeping track of the number of carbohydrates you eat at each meal. Carbohydrates from your food get digested and absorbed as a sugar, known as glucose. Counting carbohydrates allows you to be aware of how food will affect your blood glucose. This is important if you need to manage your blood sugar levels. Why Should I Use the Carbohydrate-Counting Method?Carbohydrate counting is particularly useful for people who take insulin shots since it allows you to balance food intake with insulin. The more carbohydrates you eat, the higher your blood sugar will be, and the more insulin you will need. Of course, always ask your doctor before adjusting insulin doses on your own. Carbohydrate-Counting BasicsWhen you eat carbohydrates, your body turns them into glucose. The foods that raise blood glucose the most are those that contain carbohydrates. Foods like starches, milk, fruit, and sweets are considered carbohydrates. Carbohydrates are often classified as simple or complex:
How Much Is One Serving of Carbohydrates?One carbohydrate serving is equal to 15 grams of carbohydrate. This is about the amount of carbohydrate in one slice of bread, 3/4 cup dry, unsweetened cereal,1/2 cup of pasta, one cup of milk, or one 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 carbohydrate servings. For example, you may trade one starch serving for one fruit or milk serving. The table below gives examples of foods that have approximately 15 grams of carbohydrates per serving.
Meats and fats generally contain little or no carbohydrate, while non-starchy vegetables contain only five grams per serving. One serving equals 1 cup raw vegetables or ½ cup cooked. Examples of non-starchy vegetables include:
Many sources provide comprehensive carbohydrate count lists. In addition, most packaged foods have labels with the carbohydrate amount. How Much Carbohydrate Can I Eat?Most people with diabetes should consume between 45%-65% of their calories as carbohydrates . The balance can come from fat and protein. There are four calories in every gram of carbohydrate. So, for example, if you are on a 2,000-calorie diet with 50% of your calories coming from carbohydrates, you can have a total of 16 servings of carbohydrate per day.
How you distribute these servings will affect your blood sugar. The bottom line is that you should space out your carbohydrate servings into at least three meals per day, ideally with a snack in between. This frequent and steady intake of carbohydrates will keep your blood sugar steady. In addition, the more fiber the source of carbohydrates contains, the better the effect on your blood sugar. The table below shows examples of different ways that these 16 carbohydrates servings could be distributed. Keep in mind the more evenly distributed they are, the better:
Meal PlanningA registered dietician can help you master carbohydrate counting and come up with an individualized meal plan for you. The dietician will take into consideration a number of factors, like how well you are managing your diabetes, how physically active you are, how much you weigh, and how old you are. What Should I Consider When Planning My Meal?Count Your CarbsLearn which types of foods contain carbohydrates and the amount per serving. A quick search online will turn up a range of references to help you count carbohydrates and plan diabetic meals. When grocery shopping, remember to read the food label. This will tell you the portion size and the total carbohydrate amount. For example, one granola bar can have a total of 22 grams of carbs. To be more precise with your counting, use measuring cups and spoons, as well as a food scale. For example, an apple weighing 4 ounces has about 15 grams of carbohydrates. Use a worksheet to keep track of your meals, drinks, and snacks. Share this information with your dietician so that she can check on your progress. Carb counting software programs are also available to help you stick to your meal plan. Be Aware of Foods That Are Carb-FreeNot all foods contain carbohydrates! For example, a 6-ounce serving of ground beef contains no carbohydrates, but has over 500 calories. One teaspoon of corn oil also has no carbohydrates, but has 40 calories. With this in mind, choose your proteins and fats in moderation. If they are eaten in excess, you may exceed your target calorie level and gain weight. Foods that are high in fat and cholesterol should also be limited to decrease your risk of developing cardiovascular disease. Don’t Forget About FiberFiber is a carbohydrate. But, because the body cannot 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 carbohydrate grams. This subtraction gives you a more accurate estimate of the carbohydrates that will affect your blood sugar. Make Healthy ChoicesEat a variety of healthy foods everyday by choosing:
The US Department of Agriculture’s Choose My Plate website offers more tips, like:
Sample MealAre you wondering what it would be like to eat a carb-friendly dinner? Here is just one example, but keep in mind that a dietician can create a personalized meal plan for you.
American Diabetes Association US Department of Agriculture Choose My Plate Canadian Diabetes Association Dietitians of Canada Carbohydrate counting. American Diabetes Association website. Available at: http://www.diabete.... Accessed February 13, 2013. Carbohydrate counting with chronic kidney disease. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/carbcount.cfm. Accessed February 13, 2013. Dietary considerations for patients with type 2 diabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated February 4, 2013. Accessed February 13, 2013. Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at: http://www.health..... Accessed February 13, 2013. Last reviewed February 2013 by Dianne Scheinberg Rishikof MS, RD, LDN |
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