Without getting into the deep water of randomized control trials and statistical meta analyses, it’s fair to say that managing the total carbohydrate content of meals is still considered the most effective tool for diabetes meal planning. You’re probably familiar with carb counting, at least with the concept. But, if you’re not taking it seriously yet, it’s time to start.
Your carbohydrate management plan is a component of medical nutrition therapy, and managing your carbohydrates in some ways is as important as taking your medication.
Counting to 15 grams
Carbohydrate counting (carb counting for short) doesn’t have you count each gram of carbohydrate one by one. Instead, carbohydrates are packaged into 15 gram carb choices; one carb choice for a particular food always includes approximately 15 grams carbohydrate.
The counting part is easy. If your meal plan calls for four carb choices at your evening meals, you simply include a total of four carbohydrate foods, each in a serving size that equals approximately 15 grams of carbohydrate.
You can eat four different carb choices, you can have two 15 carbohydrate gram servings of the same food (along with two more carb choices of different foods), or you could have four carb choice servings of the same food too, although variety is best. Your meal plan will make a recommendation for a specific number of carb choices at every meal, and probably a carb choice snack or two wedged in somewhere.
Just imagine that every morning you find that a fairy has left 12 or 13 tokens on your dresser, each one good for a 15 gram carbohydrate serving during the day — 4 grams for breakfast, 4 grams for lunch, 4 grams for dinner, and 4 grams for a snack. That couldn’t be any easier.
Comparing carb choices
Now for the harder part — not hard, just harder. The measure of carbohydrate containing foods — dairy or plant — that includes your 15 grams of carbohydrate is not the same from food to food. The table shows the weight, volume, or size of one carb choice for some different foods.
| Food | One Carb Choice |
|---|---|
| Maple syrup | 1 tablespoon |
| Oatmeal | 1/4 cup, dry |
| Beans | 1/3 cup cooked |
| Rice or pasta | 1/3 cup cooked |
| Unsweetened cereal | 1/2 cup |
| Milk | 1 cup* |
| Yogurt | 1 cup |
| Baked potato | 3 ounces |
| French fries | 10 fries |
| Bread | 1 slice |
| Bagel | 1/2 small bagel |
| Popcorn | 3 cups popped |
| Apple | 1 medium sized |
| Banana | 1/2 medium banana |
| Raspberries | 1 cup |
| Honeydew melon | 1 cup |
| Nonstarchy vegetables | 1-1/2 cups cooked |
| Nonstarchy vegetables** | 3 cups raw |
* 1 cup milk is actually 12 grams carbohydrate, but is considered 1 carb choice.
** Nonstarchy vegetables include asparagus, artichoke, beets, green beans, broccoli, cabbage, carrots, cauliflower, cucumber, greens, jicama, mushrooms, okra, pea pods, peppers, radishes, rutabaga, spinach, tomato, turnips, yellow and zucchini squash, and many more.
Knowing which portion size of a food you’ll eat to get each 15 gram carb choice is really necessary if you’re serious about blood glucose control. You may feel unnatural thinking so much about food. Yes, it would be nice if one carb choice for all carbohydrate foods was the same serving size, but there’s a big difference between a tablespoon of sugar and 3 cups of shredded cabbage.
If the serving size on nutrition labels always equaled 15 grams of carbohydrate it would help, but every can of beans gives nutrition information for 1/2 cup, and that’s 22 grams of carbohydrate. And what about those recipes or restaurant meals where one serving of the dish has 60 grams of carbohydrate?
There’s no need to panic. First, this isn’t rocket science, as the saying goes. Anyone who’s managed type 1 diabetes for a while, where you can carefully match grams of carbs and a precise dose of insulin, already knows that the variations in both food and your metabolism put perfection way out of reach. What’s most important is knowing what you need to know. Remember, the all-important A1C is about averages.
There’s one final calculation that’s like a discount coupon for you with some carbohydrate foods. Dietary fiber and sugar alcohols are carbohydrates that are not efficiently digested — you can find the grams of these listed on nutrition labels under total carbohydrate.
Anytime the dietary fiber or sugar alcohol amount is 5 grams or more you can deduct one half of the amount from total carbohydrate. Often the deduction isn’t much — kidney beans have 22 grams total carbohydrate and 7 grams fiber in the 1/2 cup nutrition label’s serving size, so you can deduct 3-1/2 grams from the 22 grams for an adjusted total carbohydrates of 18-1/2 grams per 1/2 cup.
Likewise, a 1/2 cup serving of a particular no sugar added ice cream has 17 grams total carbohydrate and 8 grams sugar alcohol. Because the sugar alcohol is 5 grams or more, deduct one half, 4 grams, from total carbohydrate to get net carbohydrate in the 1/2-cup serving of 13 grams.
Memorizing the one carb choice portion for foods you eat all the time is easy enough, but nobody can know everything. A good starting place is to practice visualizing the correct measurements of foods for one carb choice while you are at home.
To help you with carb food choices you may not eat as often make yourself a cheat sheet, buy a pocket-sized carb counting reference, or download a carb counting app to your smart phone. If you’re determined to be successful, easy solutions are available for you.