Making Sense of Carbohydrate Counting

By Jane Farrell

If you or a loved one have been recently diagnosed with diabetes, you know that the nutrition guidelines for diabetics can seem overwhelming at times. And following the guidelines, which include carbohydrate counting, is crucial to a diabetic’s health.

Here, from the National Diabetes Information Clearinghouse, part of the National Institutes of Health, is an easy-to-understand explanation of carbohydrate counting. This tool for planning meals will help you keep track of the amount of carbs you’re eating each day, and whether you’re in goal range.

Along with protein and fat, carbs are one of the main nutrients we get in food. Carbs are made up of sugar, starches and fiber. It’s important to count how many carbs you’re eating because they affect your blood sugar levels more than other nutrients.

Healthy carbohydrates, including whole grains and fresh fruits and vegetables, can provide you with both energy and nutrients. They’re also a source of fiber, which can help prevent constipation and control your weight. But there are also unhealthy carbs, most notably food with added sugars. While they can provide energy, they have little or no nutrients.

Unhealthy carbohydrates are often food and drinks with added sugars. Although unhealthy carbohydrates can also provide energy, they have little to no nutrients. Read more about which carbohydrates provide nutrients for good health and which carbohydrates do not in What I need to know about Eating and Diabetes at www.diabetes.niddk.nih.gov.

The amount of carbohydrate in any given food is measured in grams. The NDIC says that to get an accurate amount of the carbs you’re eating, you’ll need to know which foods contain carbohydrates, to learn to estimate the number of grams you’re eating and to add up the number of grams you eat on any given day.

The NDIC lists the following foods as containing carbohydrates:

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. These vegetables, the NDIC says have more carbs per serving than nonstarchy vegetables.

Nonstarchy vegetables include 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 you eat foods containing carbohydrates? Your digestive system breaks down sugars and starches into glucose, a form of sugar. After that, the glucose enters your bloodstream and raises your blood-sugar levels. It’s absorbed by the hormone insulin, which helps cells 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.

The NDIC emphasizes that monitoring blood glucose levels and keeping them close to normal is crucial. Doing that can help you stay healthy longer and delay or even prevent diabetes-related problems, such as kidney disease, blindness, nerve damage, and blood vessel disease that can lead to heart attacks, strokes, and even amputations.

Even if you’re taking insulin shots to control your blood glucose levels, discuss your blood sugar targets with your doctor. To meet your targets, the NDIC says, you’ll need to balance your carbohydrate intake with physical activity and diabetes medicines or insulin shots.

What makes carbohydrate counting tricky is that the daily amount of carbs, protein and fat for diabetics hasn’t been defined, the NDIC says. What’s best for one person may not be best for another. There’s no avoiding carbs, either: everyone needs to get enough to meet the body’s needs for energy, vitamins and minerals, and fiber.

As a goal, experts suggest that carb intake should, most frequently, be between 45 and 65 percent of total calories.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 carbohydrates

A dietitian or a diabetes educator can help you learn what foods you should be eating, and in what amount, based on your weight, activity level, medications and blood glucose targets.

You’ll also need to learn to estimate the amount of carbohydrates in foods, the NDIC says . For example, the agency says, these carbohydrate-rich foods each contain about 15 grams of carbohydrates:

one slice of bread

one 6-inch tortilla

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 fruit1/2 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

On the other hand, the NDIC says, some foods are so low-carb that you may not have to count them unless you eat a lot of them. 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 carbohydrates.

With practice, carb counting will become easier. The NDIC recommends looking at some materials and books from the American Diabetes Association. Visit ShopDiabetes.org.