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Carbohydrate Counting Q & A What is carbohydrate counting? Carbohydrate counting can help you control your blood glucose levels. The goal of carbohydrate counting is to keep the amount of carbohydrate that you eat consistent from day to day, and meal to meal. Carbohydrate counting is used in tandem with an overall healthy eating plan, including good portion control. You do not count calories with this diet. Why is carbohydrate counting useful for people on insulin therapy? Carbohydrate counting is essential for people with diabetes who are insulin-controlled, because the insulin dosages that are administered are adjusted to the amount of carbohydrate that you eat. Your health care professional can help you determine an individualized insulin-to-carbohydrate ratio. This ratio is different from person to person and may change over time. What foods contain carbohydrates? Carbohydrates are found in all foods, with the exception of fresh meats and fats. You will need to count the following foods, which contain carbohydrates: Breads Cereals Crackers Dairy products, such as: – Cheese – Milk – Yogurt Desserts Fruit juices Fruits Grains Honey Molasses Pasta Rice Sweets Syrup Table sugar Vegetables that are starchy vegetables, such as: – Corn – Lima beans – Peas – Potatoes – Squash Vegetables that are not starchy vegetables (nonstarchy vegetables contain little carbohydrate), such as: – Broccoli – Carrots – Green beans Can I eat sugar? You can eat sweets and sugar on occasion, if you count the carbohydrate that these foods contain and still keep your total carbohydrate intake for the day within your target range. How do I begin to count carbohydrates? Carbohydrates are measured in grams. The total grams of carbohydrate/serving of food are found on the Nutrition Facts label of commercial food products. Books also are available that list the carbohydrate content of most foods. These are especially useful when you are eating out or eating combination dishes that contain many ingredients. Measuring portion sizes is very important, especially in the beginning until you get to know what a standard serving size looks like. The magic number to remember is 15. This is because 1 carbohydrate “choice” or “serving” contains 15 grams (g) of carbohydrate. What are some examples of foods that count as 1 carbohydrate (carb) choice? The following are serving sizes for carbohydrate foods containing 15 g (1 carb choice): Fruit and fruit juices: One small orange, apple, pear, kiwi, peach, nectarine, or banana ⅓ cup (C) baked apple slices Two small plums or tangerines ½ C unsweetened applesauce One-third of a cantaloupe One slice of watermelon or honeydew melon ½ C fruit cocktail 17 grapes 2 tablespoons (Tbsp) of raisins 1¼ C whole strawberries 1 C raspberries ½ C apple, pineapple, grapefruit, or orange juice ⅓ C grape juice, prune juice, or cranberry cocktail Dairy foods: 1 C milk (fat content does not matter for carbohydrate counting) 1 C buttermilk ½ C evaporated milk 1 C lite yogurt ½ C ice cream or pudding Starchy vegetables: ½ C corn 1 C mixed vegetables containing corn or peas ½ C peas ½ C mashed potatoes One small baked potato or sweet potato ½ C winter squash ½ C baked beans ½ C cooked dry beans ⅔ C lima or butter beans Nonstarchy vegetables: 3 C raw or 1½ C cooked of any vegetable not listed on the starchy vegetable list (example: 3 C lettuce or 1½ C cooked carrots each count as 1 carb choice) Breads: One slice of bread Two slices of lite bread ½ hamburger or hot dog bun One-half of an English muffin One 4″ pancake or waffle One 6″ corn or flour tortilla Cereals and grains: ⅓ C rice ⅓ C pasta ⅓ C bread stuffing ½ C cooked cereal ½ C bran cereal ½ C sugar-frosted cereal 1½ C puffed cereal ¾ C unsweetened cereals Snacks: Six soda crackers (saltines) Eight animal crackers 3 C no-fat or low-fat air-popped popcorn ¾ ounces pretzels Three gingersnaps Five vanilla wafers ¼ C sherbet One-half of a small glazed doughnut 15 potato chips What about foods that I make myself? Here are some general guidelines that might help you out: 1 C lasagna =2 carb choices 1 C spaghetti with meat sauce=3 carb choices 1 C macaroni and cheese=3 carb choices One-fourth of a 12″ pizza with thin crust=2 carb choices One potpie=3 carb choices 1 C of most soups=1 carb choice One medium serving of French fries=3 carb choices One soft taco or two hard-shell tacos=1 carb choice 1 C chili=2 carb choices How can I use the food label to help me count carbohydrates? Remember that 15 g is 1 carb serving. However, the carbohydrate content of food is not always perfectly divisible by 15, which can make it tricky. Check the food label for the size of the serving and then compare the number of carbohydrates to the following chart: Carb Choice(s) 1 2 3 4 Range of Carbohydrate (g) 8-22 g 23-37 g 38-52 g 53-65 g What else do I need to know? Meals Eating meals at the same time every day and not skipping meals is important for controlling blood glucose levels. Protein and fat Although you do not need to count protein or fat grams on this diet, you still should try not to eat too much food overall. Eating too much can affect blood sugar levels in the short term and cause weight gain in the long term. Overweight individuals can have problems controlling their blood glucose levels. In addition, people with diabetes are at higher than average risk for heart disease, and eating too many of the wrong types of food can increase your risk of heart disease even more. Fiber A diet that is high in fiber provides many health benefits, including lowering total cholesterol levels and possibly decreasing the rise of blood glucose following a meal. It is recommended that: Women 19 to 50 years of age have 25 g of dietary fiber/day Women 51 years of age and older have 21 g of dietary fiber/day Men 19 to 50 years of age have 38 g of dietary fiber/day Men 51 years of age and older have 30 g of dietary fiber/day An excellent source of fiber is one that contains 5 g or more of fiber/serving; a good source contains 2.5-4.9 g/serving. For foods that contain 5 g or more of fiber/serving, subtract half the number of grams of fiber from the total grams of carbohydrate/serving of that food when counting carbohydrates, because dietary fiber is only partially digested. Sugar-free foods Remember that sugar-free foods still often contain carbohydrate from other sources and may even have more calories than the regular version. Look carefully at all nutrition labels before making a purchase, because many are confusing or even misleading. References and recommended readings American Diabetes Association®. Carbohydrate counting. Diabetes.org Web site. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understandingcarbohydrates/carbohydrate-counting.html. Updated March 11, 2014. Accessed March 29, 2014. American Diabetes Association. Understanding carbohydrates. Diabetes.org Web site. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/carbohydrates.html. Accessed March 29, 2014. Wheeler ML, Pi-Sunyer FX. Carbohydrate issues: type and amount. J Am Diet Assoc. 2008;108(4 suppl 1):S34-S39. doi:10.1016/j.jada.2008.01.024. Review Date 3/14 D-0507