Carbohydrate Counting (Quiz Number: Manatee )

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1 Page 1 The goal of Carbohydrate Counting is to make clear to you which foods affect your blood glucose and then to spread these foods evenly throughout the day (or to match insulin peaks and durations). This lets you reach your blood glucose goals and thus, prevent diabetes complications. What is Carbohydrate Counting? What is a carbohydrate? Are some carbs better than others? How many carbs should I eat? Reading a food label What is Carbohydrate counting? What is Carbohydrate Counting? Carbohydrate Counting is one method of meal planning for people with diabetes. Carbohydrate Counting guides you in choosing what and how much to eat. The advantages of using Carbohydrate Counting are: Helps to prevent high and low blood glucose fluctuations Helps with healthy weight loss and maintenance Gives flexibility for your preferences, or treats Less guess work for those who take insulin Eating approximately the same number of carbohydrate choices for each meal and snack and from day to day helps control blood glucose levels. Carbohydrate Counting along with an overall healthy eating pattern, including good portion control will promote general good health. What is a carbohydrate? Carbohydrate is one of the six nutrients that make up food (the other five nutrients are protein, fat, vitamins, minerals and water). Carbohydrates are essential to life because they are your body s fuel source. They are a special concern for people with diabetes because foods high in carbohydrates tend to raise blood sugar. This is not a bad thing and you do not want to cut carbohydrates out of your diet completely. People with diabetes need carbohydrates for fuel and energy. The healthy way to eat carbohydrates it to calculate (more on this later) how many carbohydrates you need at each meal and snack and then try to stick with this. In order to start Carbohydrate Counting you must first learn what food groups are high in carbohydrates. We call these foods, carbs for short. It would be wise to memorize these carbohydrate food groups. This is so you can look at a buffet table of food and think, this food or dish will affect my blood glucose, this one won t etc. and then make your selections based on this knowledge. If you do not memorize which food groups are carbs you will either have to carry around a little

2 Page 2 booklet or you will be making guesses. When you guess you will be wrong sometimes and end up with high or low blood glucose. Lets go through each of these five groups. Fruit Milk Starches What is a carb? Starchy vegetables Sugar FRUIT All fruit is healthy. In the old days of diabetes care, people with diabetes were told to avoid fruit. It was thought to be too sugary. Today, we know this is not true. Fruit actually makes your blood glucose rise more slowly than grains and grain products such as rice, crackers, cereal and bread. MILK This group consists of milk, yogurt and ice cream. Cheese is not in this group, it is considered a protein instead of a carb. STARCH Any food that is a grain or made from grain is in this group. Includes bread, cereal, rice, pasta, bagels, tortillas, waffles, crackers. STARCHY VEGETABLES There are just a few veggies considered to be a carb. These are: potatoes, corn, peas, beans and sweet potatoes. Peas, beans and sweet potatoes have less concentrated carbs than potatoes and corn, so they are better choices. All other vegetables not mentioned above are free. Which means you can eat as much as you want of these non-starchy vegetables; they do not raise your blood glucose. In fact, the non-starchy vegetables can help to keep your blood glucose from rising as much if you do consume a food or meal high in carbs. Just eat a large portion of a non-starchy veggie or a salad before you eat something high in carbs (pasta, rice or mashed potatoes, pizza etc) and you will see your blood glucose will not rise as much as if you had eaten the carb alone. SWEETS AND SNACKS Examples of foods in this group are cookies, pudding, candy, cakes, pastries, regular soda pop, corn chips, cheese puffs, potato chips, popcorn, chocolate, sugar and honey. People with diabetes can eat sweets, but like any American, they should not be eaten every day, just occasionally. This is because they have little to no nutritional value and lots of fat and calories and sometimes sodium, too.

3 Page 3 Are some carbs better than others? Yes, indeed some carbs are better than others. Your body is smart. It wants to burn quality fuel, not poor quality fuel. Quality fuel, in the form of healthy carbs, raises your blood glucose slowly, burns more slowly and lasts longer than poor quality carbs which raise your blood glucose quickly and quite high, then are gone. Quality carbs will keep you energized and full. Poor quality carbs will may give you a burst of energy at first, but this will not last and you may end up feeling low or sleepy. They also will not keep you full and you may crave more poor quality carbs again in a little while. Here is a chart to help guide you in choosing mostly high quality carbs. Try to limit the amount and how often you eat the poor quality carbs. Quality Carbs Poor Quality Carbs Fruit All fruits Fruit juices. Tropical fruits (bananas, pineapple, mango, papaya) are more sugary and should be eaten in smaller quantities. Milk Starches Starchy veggies Sweets & snacks Skim or 1% milk, yogurt, light ice cream or diet ice cream bars Whole grain bread, whole grain cereal (Cheerios, bran flakes, wheat chex, etc), oatmeal, brown rice, whole wheat or low carb pasta Beans, peas, sweet potatoes, squash (remember all other veggies are free) Triscuits and other whole grain crackers, whole wheat pretzels, graham crackers, artificial sweetener, diet syrup 2% or whole milk, regular ice cream, White bread, sweet or frosted cereal, white rice, pasta, bagels Potatoes (mashed, french fries, baked (small baked is better than mashed, augratin or fries), corn Saltines, Ritz, cookies (better cookies are ginger snaps, vanilla wafers and animal crackers), candy, cake, donuts, pastries, potato chips, corn chips, Doritos, cheese puffs, soda, sugar, honey, syrup

4 Page 4 How many carbs should I eat? Carbs are measured in grams (g). The amount of carbs you should eat depends on your age, height, weight, activity level and if you are a male or female. If you want an individualized Carbohydrate Counting plan, see your Diabetes Educator or Registered Dietitian. For this learning module, we can use an estimate. Estimate for carb intake Meal = grams Snack = grams *Note: If you have any of the following characteristics you should eat the lower number of carbs at each meal or snack. Female, older age, not active, short, overweight. If you have any of these following characteristics you should eat the higher number of carbs at each meal or snack. Male, young, active, tall, healthy weight. It needs to be emphasized that this is only an estimate. Individual nutrition and carb needs vary quite a bit. See your Diabetes Educator or Registered Dietitian. For those of you taking insulin, the timing of your meals and snacks and how many carbs you eat should match when your insulin peaks. Please meet with your Diabetes Educator for help with this as it can be a little complicated.

5 Page 5 With the Carbohydrate Counting system, 15 is our lucky number and we count by 15. This is because one carb unit/portion/serving consists of 15 grams (g). Thus if we say 45 g for each meal, think 45 divided by 15 is 3. This means that a 45 g meal could be: 3 units/portions of one carb food or 1 units/portion of 3 different carb foods or 2 units/portions of 1 carb food and 1 unit of another carb food Here are examples of this. 3 units/portions of one carb food like 3 slices of bread 1 units/portion of 3 different carb foods such as 1 slice bread, 1 pear and ½ cup lima beans 2 units/portions of 1 carb food and 1 unit of another carb food like 1 cup lima beans and 1 slice bread Make an effort to eat about the same amount of carbs at each meal. Try to have a minimum of 1 carb choice (15 grams) at both breakfast and lunch to keep your blood glucose from going low and your metabolism going strong). Don t skip breakfast! At least eat a piece of fruit if you can t handle anything else. In most cases, it is better to have a little less carbs at a meal than too much. At dinnertime, it is probably OK to eat zero carbs if you would like or if you are trying to lose weight. This means just protein and non-starchy vegetables (ex. Chicken and broccoli, Steak and salad, Fish and tomatoes, Porkchops and green beans). Remember, you can eat all you want of non-starchy vegetables! Eating zero carbs at dinner is not OK if you take insulin before dinner or at night. The total grams of carbohydrate per serving of food are listed on the Nutrition Facts food label of processed foods and are also in books. You can get a free carbohydrate counting book by visiting Manatee County s Diabetes Educator. A book is especially useful when you are eating combination dishes that contain many ingredients or when you are dining out.

6 Page 6 Reading a food label You can use the food label to help count carbohydrates. Remember that 15 g is one carbohydrate serving. However, the carbohydrate content of food is not always perfectly divisible by 15, which can make it a bit tricky. Check the food label for the size of the serving and then compare the number of carbohydrates to the chart below: Carbohydrate Choice(s) Range of Carbohydrate Grams (g) g g g g Remember that sugar-free foods still often contain carbohydrate from other sources and may even have more calories than the regular version. Look carefully at all nutrition labels before making a purchase, because many are confusing or even misleading. What else do I need to know? Eating meals at the same time every day and not skipping meals is important for controlling blood glucose levels. Although you do not need to count protein or fat grams with a carbohydrate counting plan, you should still try not to eat too much food overall. Eating too much can affect blood sugar levels in the short term and cause weight gain in the long term. Overweight individuals can have problems controlling their blood glucose levels. In addition, people with diabetes are at higher than average risk for cardiovascular disease (heart attack, stroke, circulatory problems), and eating too much in general, especially meats high in fat, cheese, fried foods, junk foods and sweets can increase your risk of heart disease even more. In short, try to eat more vegetables, more fruits, more lean proteins and less grains, processed foods, snack foods. Good luck with your carbohydrate counting! Remember, you can always get an individual nutrition plan or help with any diabetes care issue just by setting up a meeting with Manatee County s Diabetes Educator.

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