What I
need to know about Carbohydrate Counting and Diabetes
What is carbohydrate counting?
Carbohydrate* counting, also called carb counting, is a
meal planning tool for people with type 1 or type 2 diabetes. Carbohydrate
counting involves keeping track of the amount of carbohydrate in the foods you
eat each day.
Carbohydrates are one of the main nutrients
found in food and drinks. Protein and fat are the other main nutrients.
Carbohydrates include sugars, starches, and fiber. Carbohydrate counting can
help you control your blood glucose, also called blood sugar, levels
because carbohydrates affect your blood glucose more than other nutrients.
Healthy carbohydrates, such as whole grains, fruits, and vegetables, are
an important part of a healthy eating plan because they can provide both energy
and nutrients, such as vitamins and minerals, and fiber. Fiber can help you
prevent constipation, lower your cholesterol
levels, and control your weight.
Unhealthy carbohydrates are often food and drinks with added sugars.
Although unhealthy carbohydrates can also provide energy, they have little to
no nutrients.
The amount of carbohydrate in foods is measured in grams. To count grams
of carbohydrate in foods you eat, you’ll need to
·
know
which foods contain carbohydrates
·
learn to
estimate the number of grams of carbohydrate in the foods you eat
·
add up
the number of grams of carbohydrate from each food you eat to get your total
for the day
Your doctor can refer you to a dietitian or
diabetes educator who can help you develop a healthy eating plan based on
carbohydrate counting.
Which foods contain
carbohydrates?
Foods that contain carbohydrates include
·
grains,
such as bread, noodles, pasta, crackers, cereals, and rice
·
fruits,
such as apples, bananas, berries, mangoes, melons, and oranges
·
dairy
products, such as milk and yogurt
·
legumes,
including dried beans, lentils, and peas
·
snack
foods and sweets, such as cakes, cookies, candy, and other desserts
·
juices,
soft drinks, fruit drinks, sports drinks, and energy drinks that contain sugars
·
vegetables,
especially “starchy” vegetables such as potatoes, corn, and peas
Potatoes, peas, and corn are called starchy vegetables because they are
high in starch. These vegetables have more carbohydrates per serving than
nonstarchy vegetables.
Examples of nonstarchy vegetables are asparagus, broccoli, carrots,
celery, green beans, lettuce and other salad greens, peppers, spinach,
tomatoes, and zucchini.
Foods that do not contain carbohydrates include meat, fish, and poultry;
most types of cheese; nuts; and oils and other fats.
What happens when I eat foods
containing carbohydrates?
When you eat foods containing carbohydrates, your digestive system
breaks down the sugars and starches into glucose. Glucose is one of the
simplest forms of sugar. Glucose then enters your bloodstream from your
digestive tract and raises your blood glucose levels. The hormone insulin, which comes from the pancreas or
from insulin shots, helps cells throughout your body absorb glucose and use it
for energy. Once glucose moves out of the blood into cells, your blood glucose
levels go back down.
How can carbohydrate counting
help me?
Carbohydrate counting can help keep your blood glucose levels close to
normal. Keeping your blood glucose levels as close to normal as possible may
help you
·
stay
healthy longer
·
prevent
or delay diabetes problems such as kidney disease, blindness, nerve damage, and
blood vessel disease that can lead to heart attacks, strokes, and amputations—surgery to remove a body part
·
feel
better and more energetic
You may also need to take diabetes medicines or have insulin shots to
control your blood glucose levels. Discuss your blood glucose targets with your
doctor. Targets are numbers you aim for. To meet your targets, you will need to
balance your carbohydrate intake with physical activity and diabetes medicines
or insulin shots.
How much carbohydrate do I need
each day?
The daily amount of carbohydrate, protein, and fat for people with
diabetes has not been defined—what is best for one person may not be best for
another. Everyone needs to get enough carbohydrate to meet the body’s needs for
energy, vitamins and minerals, and fiber.
Experts suggest that carbohydrate intake for most people should be
between 45 and 65 percent of total calories. People on low-calorie diets and
people who are physically inactive may want to aim for the lower end of that
range.
One gram of carbohydrate provides about 4 calories, so you’ll have to
divide the number of calories you want to get from carbohydrates by 4 to get
the number of grams. For example, if you want to eat 1,800 total calories per
day and get 45 percent of your calories from carbohydrates, you would aim for
about 200 grams of carbohydrate daily. You would calculate that amount as
follows:
·
.45 x
1,800 calories = 810 calories
·
810 ÷ 4 =
202.5 grams of carbohydrate
You’ll need to spread out your carbohydrate intake throughout the day. A
dietitian or diabetes educator can help you learn what foods to eat, how much
to eat, and when to eat based on your weight, activity level, medicines, and
blood glucose targets.
How can I find out how much
carbohydrate is in the foods I eat?
You will need to learn to estimate the amount of carbohydrate in foods
you typically eat. For example, the following amounts of carbohydrate-rich
foods each contain about 15 grams of carbohydrate:
·
one slice
of bread
·
one
6-inch tortilla/roti
·
1/3 cup
of pasta
·
1/3 cup
of rice
·
1/2 cup
of canned or fresh fruit or fruit juice or one small piece of fresh fruit, such
as a small apple or orange
·
1/2 cup
of pinto beans
·
1/2 cup
of starchy vegetables such as mashed potatoes, cooked corn, peas, or lima beans
·
3/4 cup
of dry cereal or 1/2 cup cooked cereal
·
1
tablespoon of jelly
Some foods are so low in carbohydrates that you may not have to count
them unless you eat large amounts. For example, most nonstarchy vegetables are
low in carbohydrates. A 1/2-cup serving of cooked nonstarchy vegetables or a
cup of raw vegetables has only about 5 grams of carbohydrate.
As you become familiar with which foods contain carbohydrates and how
many grams of carbohydrate are in food you eat, carbohydrate counting will be
easier.
Nutrition Labels
You can find out how many grams of carbohydrate are in the foods you eat
by checking the nutrition labels on food packages. Following is an example of a
nutrition label:
Cooking at Home
To find out the amount of carbohydrate in homemade foods, you’ll need to
estimate and add up the grams of carbohydrate from the ingredients. You can use
books or websites that list the typical carbohydrate content of homemade items
to estimate the amount of carbohydrate in a serving.
You can also weigh foods with a scale or measure amounts with measuring
cups or spoons to estimate the amount of carbohydrate. For example, if a
nutrition label shows that 1 1/2 cups of cereal contain 45 grams of
carbohydrate, then 1/2 cup will have 15 grams of carbohydrate and 1 cup will
have 30 grams of carbohydrate.
Eating Out
Some restaurants provide nutrition information that lists grams of
carbohydrate. You can also use carbohydrate counting food lists to estimate the
amount of carbohydrate in restaurant meals. See "Where can I find more help
with carbohydrate counting?" for some resources.
Can I eat sweets and other foods
and drinks with added sugars?
Yes, you can eat sweets and other foods and drinks with added sugars.
However, you should limit your intake of these high-carbohydrate foods and
drinks because they are often high in calories and low in vitamins, minerals,
and fiber. Fiber-rich whole grains, fruits, vegetables, and beans are wiser
choices.
Instead of eating sweets every day, try eating them in small amounts
once in a while so you don’t fill up on foods that are low in nutrition. Ask
your dietitian or diabetes educator about including sweets in your eating plan.
What are added sugars?
Added sugars are various forms of sugar added to foods or drinks during
processing or preparation. Naturally occurring sugars such as those in milk and
fruits are not added sugars but are carbohydrates. The most common sources of
added sugars for are
·
sugar-sweetened
soft drinks, fruit drinks, sports drinks, and energy drinks
·
grain-based
desserts, such as cakes, cookies, and doughnuts
·
milk-based
desserts and products, such as ice cream, sweetened yogurt, and sweetened milk
·
candy
Reading the list of ingredients for foods and drinks can help you find
added sugars, such as
·
sugar,
raw sugar, brown sugar, and invert sugar—a mixture of fructose and glucose
·
corn
syrup and malt syrup
·
high-fructose
corn syrup, often used in soft drinks and juices
·
honey,
molasses, and agave nectar
·
dextrose,
fructose, glucose, lactose, and sucrose
For a healthier eating plan, limit foods and drinks with added sugars.
How can I tell whether
carbohydrate counting is working for me?
Checking your blood glucose levels can help you tell whether
carbohydrate counting is working for you. You can check your blood glucose
levels using a glucose meter.
You should also have an A1C blood test at least twice a year. The A1C
test reflects the average amount of glucose in your blood during the past 3
months.
If your blood glucose levels are too high, you may need to make changes
in your eating plan or other lifestyle changes. For example, you may need to
make wiser food choices, be more physically active, or make changes to your
diabetes medicines. Talk with your doctor about what changes you need to make
to control your blood glucose levels.
If you use an insulin pump or take more than one daily insulin shot, ask
your doctor how to adjust your insulin when you eat something that isn’t in
your usual eating plan.
Can I use carbohydrate counting
if I am pregnant?
You can use carbohydrate counting to help control your blood glucose
levels when you are pregnant. Meeting your blood glucose targets during
pregnancy is important for your and your baby’s health. High blood glucose
during pregnancy can harm the baby and increase the baby’s chances of having
type 2 diabetes later in life.
Women diagnosed with gestational
diabetes—a type of diabetes that develops only during pregnancy—can also use
carbohydrate counting to help control their blood glucose levels.
Talk with your doctor about using carbohydrate counting to help meet
your blood glucose targets during your pregnancy.
Read more about diabetes during pregnancy in the following booklets at www.diabetes.niddk.nih.gov:
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Where can I find more help with
carbohydrate counting?
The Internet has carbohydrate counting tools that let you enter a type
of food and find out what nutrients the food contains, including carbohydrates.
Try visiting these sites:
·
www.diabetes.org/mfa-recipes/
—a calorie and carbohydrate
counting tool from the American Diabetes Association (ADA)
—a calorie and carbohydrate
counting tool from the American Diabetes Association (ADA)
·
www.nal.usda.gov/fnic/foodcomp/search—an
online database from the U.S. Department of Agriculture Nutrient Data Lab
Many books about carbohydrate counting and meal planning for people with
diabetes are available. The ADA has several books available for purchase at www.shopdiabetes.org.
.
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Points to Remember
·
Carbohydrate
counting is a meal planning tool for people with type 1 or type 2 diabetes.
Carbohydrate counting involves keeping track of the amount of carbohydrate in
the foods you eat each day.
·
Carbohydrates
are one of the main nutrients found in food and drinks. Carbohydrates include
sugars, starches, and fiber.
·
Carbohydrate
counting can help you control your blood glucose, also called blood sugar,
levels because carbohydrates affect your blood glucose more than other
nutrients.
·
Carbohydrates
are an important part of a healthy eating plan because they provide energy.
Most foods containing carbohydrates also contain important vitamins and
minerals. Many foods that contain carbohydrates are good sources of fiber,
which can help you prevent constipation, lower your cholesterol levels, and
control your weight.
·
To count
carbohydrates, you’ll need to know which foods contain carbohydrates and learn
to estimate the number of grams of carbohydrate in the foods you eat. Then
you’ll add up the number of grams of carbohydrate from each food you eat to get
your total for the day.
·
Foods
that contain carbohydrates include grains, fruits, dairy products, vegetables,
legumes, snack foods and sweets, and drinks that contain sugar. When you eat
carbohydrates, your digestive system breaks down the sugars and starches into
glucose.
·
To meet
your blood glucose targets, you will need to balance your carbohydrate intake
with physical activity and diabetes medicines or insulin shots.
·
Nutrition
labels on food packages tell you the food’s serving size, the total grams of
carbohydrate per serving, and other nutrition information.
·
Foods and
drinks with added sugars are high-carbohydrate foods that are often high in
calories and low in vitamins, minerals, and fiber. Fiber-rich whole grains,
fruits, vegetables, and beans are wiser choices.
Ref: http://diabetes.niddk.nih.gov/dm/pubs/carbohydrate_ez/index.aspx
