If you have diabetes, counting carbohydrates is a helpful method for managing food intake and blood glucose levels. While any food is allowed in moderation, to ensure that you eat healthfully the American Dietetic Association recommends that your focus should be on whole grains, fruits, vegetables, beans and low-fat milk. Sweets should be saved as occasional treats. Also, while meats and fats do not contain carbohydrate, include a source of lean protein and a heart-healthy fat to round out your meals.
Diabetes
The American Diabetes Association, or ADA, defines diabetes as a group of diseases characterized by high blood glucose levels, or hyperglycemia. Ninety percent of those with diabetes have type 2, in which the body does not produce enough insulin or the cells ignore the insulin. Insulin is a hormone produced by the pancreas that is necessary for your body to be able to use glucose for energy. In type 1 diabetes, the pancreas does not produce any insulin.
Carbohydrates and Blood Glucose
Carbohydrate is the main nutrient that affects blood glucose levels. When you eat, your body breaks down all of the carbohydrates, or sugars and starches, into glucose, which is then absorbed into the blood. As described by the ADA, insulin takes sugar from the blood into the cells to be used as a fuel source. Without enough working insulin, glucose builds up in the blood instead of going into cells. Over time, this hyperglycemia can lead to complications.
Management Goals
No matter what type of diabetes you have, the treatment goals are the same. According to the American Dietetic Association, there are three primary goals. First, to keep blood glucose levels as close to normal as possible. Second, to reduce the risk of heart disease and stroke. This includes keeping blood pressure normal and achieving a healthy cholesterol level. Third, to adopt a diet and lifestyle that are enjoyable and doable for you and that can prevent or slow complications from diabetes. As part of a healthy eating plan, it is important that you eat meals and snacks regularly, eat about the same amount of food at each meal or snack and choose healthful foods for a healthy weight and heart.
Carbohydrate Counting
According to the ADA, carbohydrate counting is a meal planning technique for managing your blood glucose levels. This method can be done either by counting the number of servings of carbohydrate foods or by calculating the grams of carbohydrates consumed at meals and snacks. By keeping track of how many carbohydrates you eat and setting a limit for your maximum amount to eat, you can help to keep your blood glucose levels in your target range. The Joslin Diabetes Center reports that carbohydrate counting provides greater flexibility while allowing for tighter blood glucose control.
Sources of Carbohydrate
The primary carbohydrate-containing food groups are starches, fruits and milk. Starches include breads, cereals, rice, dried beans and starchy vegetables like potatoes and corn. Fruits include fresh, frozen, canned or dried fruit and fruit juices. The milk group also includes yogurt. Of course, sweets and snack foods like sodas, juice drinks, cake, cookies, candy and chips also contain carbohydrate. Non-starchy vegetables like salad greens, broccoli, carrots, tomatoes, green beans, summer squash and peppers have a little bit of carbohydrate but in general are very low.
Carbohydrate Recommendations
According to the Joslin Diabetes Center, the right amount of carbohydrate for you is based on your weight and height, activity level, medications, weight goals, age, laboratory values, personal preferences, other medical issues, and cultural background and lifestyle. A good place to start is to aim for 45 to 60g carbohydrate at a meal, according to the ADA. If counting servings, this would be three to four carbohydrate servings. For a snack, 15 to 30g---or one to two servings--would be an appropriate amount. You may need more or less carbohydrate at meals depending on how you manage your diabetes. Meet with a registered dietitian to figure out the right amount for you. Once you know how much carbohydrate to eat at a meal, choose your food and portion size to match.
Label Reading
Read food labels to get the most accurate information when calculating grams of carbohydrate. The two key pieces of information on the nutrition facts panel are the serving size and the grams of total carbohydrate. The total carbohydrate includes sugar, starch and fiber that is present in the food. Be aware that the term "sugar-free" on a food label only means that no sugar was added during processing. The product may still contain carbohydrates from sugar or starch that occurs naturally in the food. Or ingredients such as fruit juice concentrate or sugar alcohols may have been added.
References
- American Dietetic Association: Diabetes and Diet
- American Diabetes Association: Diabetes Basics
- American Diabetes Association: Carbohydrates
- Joslin Diabetes Center: Carbohydrate Counting 101
- Joslin Diabetes Center: How Much Carbohydrate Should I Be Eating in a Day?
- American Diabetes Association: Carbohydrate Counting
