Carb. Counting Made Easy

A certified diabetes educator discusses carbohydrate (carb) counting and its role in the diabetic diet.

**Important note: This article is for informational purposes only and does NOT take the place of meal planning with a registered dietitian, or the advice of your medical doctor.**

For the diabetic, good glucose is essential. Part of achieving this can include following a diet, prescribed by a registered dietitian, and individualized to the person's needs. One form of diabetic diet includes the concept of counting carbohydrates. Some medical centers use carbohydrate counting instead of the "exchange system".

What are carbohydrates? Carbohydrates are one of three primary substances in the foods that we eat, which also includes protein and fat. They are also the substances which turn 100 % into glucose in the bloodstream. They include all sugars and starches in the diet. In fact, carbohydrates are actually either simple sugars or complex sugar molecules, such as starches.

In a balanced diet, carbohydrates will be included, and are necessary for both energy and good health. But for the diabetic, learning to measure the amount of carbohydrate in the diet can be a useful tool in learning to control blood sugars.

How do you measure carbohydrates? First, it is important to look at how many choices have been prescribed by your dietitian. One carbohydrate choice is equal to 15 grams of carbohydrate. The dietitian will give a certain number of carbohydrate choices per meal. In the meal plan, a person might have, for example, 3 carbohydrate choices (45 grams total) for each meal, and one choice ( 15 grams) at night for a bedtime snack.

The carb allowance might look like this:

Breakfast: 45 grams carb Lunch: 45 grams carb Dinner: 45 grams carb



Bedtime: 15 grams carb

The person will choose their choices from a list of carbohydrates, remembering that one choice is 15 grams. The carbohydrate groups on the food pyramid include:

Milk

Fruits

Vegetables (although this group is lower in carb than the other groups)

Starches

Sweets

One carbohydrate choice from the milk group is equal to one cup, preferably low fat or skim for adults. Many people do not realize that milk can raise the blood sugar, because it doesn't "taste sweet", but it does contain lactose, which will turn to glucose. One container of sugar free, fat free yogurt is also equal to one carb choice. One cup of milk is actually 12 grams of carbohydrate, but it rounded up to one choice for simplicity.

Buttermilk is the same.

One carbohydrate choice from the fruit group is one small piece of fruit, about the size of your rounded fist: one apple, or one pear, one plum, one orange, for example. One half of a regular sized banana is one choice. One half cup of most fruit juices, such as orange juice, is one choice. One cup of raspberries or melon is also one choice. 12 to 15 grapes (dependent upon size) are one choice.

The vegetable group is lower in carbohydrate. One serving from this group is typically ½ cup cooked, or 1 ½ cups uncooked, and is only equal to FIVE grams of carbohydrate, or one third of a carbohydrate choice. Practically speaking, this means that you can eat a little more freely from this group, since it has less effect on raising the blood sugar. Lettuce, tomatoes, carrots, beets, brocolli, greens, etc. are examples of this group.

The cereal/starch group includes bread, pastas, starchy vegetables, and cereals. In general, one half cup cooked is a good guideline in this group: one half cup cooked hot cereal, or pasta, is one carbohydrate choice. One slice of bread, or one 6 inch tortilla, is also one choice. Rice is an exception: one third cooked is one choice, and one carb choice of beans is one third cup cooked. Most dry cereals should be checked on the food label under "Total carbohydrate". It will show how many grams of carbohydrate are in one serving, and servings can be measured accordingly (remember to count the carb in milk used, too!)

One half cooked potatoes, peas, or corn is equal to one choice. These are considered starches in the diabetic diet.

Sweets are a more concentrated form of carbohydrate, and can be part of the diabetic diet if included as part of the total carbohydrate allowed. No longer is it true that the diabetic can not have sugar in their diet; but they need to plan it as part of their complete meal plan. For example, about ½ cup of most ice creams is equal to one carbohydrate choice. But beware of "low fat" varieties, and some "sugar free" items, such as sugar free cookies: they may contain as much or more carbohydrate as the regular item. Many "low fat" foods use more sugar or sweeteners to make up for the lack of fat.

Free foods contain less than 20 calories per serving and are not counted as carbohydrate choices. These can include:

Coffee or tea, sugar free soft drinks, fat-free bouillion or broth, celery, peppers, cucumbers, salsa are examples of this group. Seasonings are also free, such as garlic powder, herbs, paprika, etc.

Be aware that counting carbohydrates is only one part of a well balanced meal plan. Eating foods that are lower in fat, higher in fiber, and learning to make healthier choices overall, such as eating more whole grains, can be incorporated in a meal plan that can help to lower triglycerides, or meet other goals, such as weight loss, if indicated. This is why meeting with a registered dietitian to plan an individualized meal plan is paramount. Hopefully, this article will help take some of the mystery from "carb counting" and will help in making better choices.

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