The Truth About Carbs
What you can eat depends on your needs.
Low-carb. No-carb. Good carbs. Bad carbs. How much? When? What type of carb? A person with diabetes could really get confused about carbohydrates (carbs), but this is an important topic to understand because carbohydrates are the foods that break down into sugar (glucose) and have the largest effect on a person's blood sugar. Most people think of bread, pasta, potatoes, and rice as carb-containing foods. These foods are carbohydrates, but fruit, juice, milk, yogurt, and sweet-containing foods, such as cookies and cakes, and snack foods like chips, pretzels, and crackers also contain carbs. It is not necessary for a person with diabetes to avoid carbs, but it is important to eat the right amount and to choose the most nutritious types of carb. Because carbs break down into sugar and can raise blood sugar levels, they should not all be eaten at the same time, but rather spread evenly throughout the day. For example, a person should not avoid carbs during the day and save all their carbs for dinner because this can cause an elevated blood sugar level in the evening or cause low blood sugar (hypoglycemia) during the day.
How many carbs should you eat? A registered dietitian (RD) or certified diabetes educator (CDE) can work with you on how many carbs to eat based on your weight, activity level, need for weight loss, or to match your insulin dose. Carbs are listed according to portion sizes as follows:
One carb choice equals:
1 slice bread
1/2 cup cooked cereal
1/3 cup cooked rice or pasta
1/2 cup mashed or sweet potatoes
1/2 cup peas or corn
1 small piece fruit
1 cup berries or melon
1/2 cup juice
1 cup skim or 1% milk
6 ounces light yogurt
One carb choice contains 15 grams Total Carbohydrate, which means that one slice of bread or one cup berries contains approximately 15 grams total carbohydrate. Total carbohydrate amount is listed on all food labels, so you can look at the amount of carbohydrate in a food and determine how many carb choices it equals. For example, a frozen dinner meal that contains 45 grams of total carbohydrates equals three carb choices. Most people with diabetes can eat between two to four carb choices (30-60 grams carb) per meal. A middle-aged woman looking to lose weight might be given two carb choices (30 grams carb) per meal and a younger active woman may be given four carb choices (60 grams carb) per meal. Again an RD or CDE can help you determine how many carbs to eat per day.
In addition to the amount of carbs eaten, the type of carb is also very important. Whole-grain and natural carbs are better choices than refined or processed carbs. For example, brown rice, oatmeal, fresh fruit, skim milk, and whole-grain crackers are healthier carb choices because they provide more vitamins, minerals, or fiber when compared to chips, cookies, sugar-sweetened cereal, and white bread. Many people are eating too many unhealthy carb foods. By learning more about carbohydrates and making changes in your eating habits you can see improvements in your blood sugar levels.
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I had a work dinner last night with some leadership from my office. I always find diabetes etiquette at these things to be kind of tricky. It was a four course meal, with salad, soup, entree' and dessert and coffee. There was also a selection of gluten free and non-gluten free dinner rolls. I felt way too full of questions for waitress... "Could I get my dressing on the side? How much sugar is in it?" A course later...