Carbohydrate
concerns for Diabetics
Foods that contain carbohydrate
raise blood glucose. 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. You may also be interested in our book, Diabetes Carbohydrate and Fat Gram Guide, 3rd
Edition.
Did you know there are three main
types of carbohydrate? There are
You'll also hear terms like
naturally occurring sugar, added sugar, low-calorie sweeteners, sugar alcohols,
reduced-calorie sweeteners, processed grains, enriched grains, complex
carbohydrate, sweets, refined grains, and whole grains.
No wonder knowing what kind and how
much carbohydrate to eat can be confusing!
On the nutrition label, the term
"total carbohydrate" includes all three types of carbohydrates. This
is the number you should pay attention to if you are carbohydrate counting.
Foods high in starch include:
- Starchy vegetables like peas, corn, lima beans, and potatoes
- Dried beans, lentils, and peas such as pinto beans, kidney beans, black eyed peas, and split peas
- Grains like oats, barley, and rice. (The majority of grain products in the US are made from wheat flour. These include pasta, bread, and crackers but the variety is expanding to include other grains as well.)
The grain group can be broken down
even further into whole grain or refined grain.
A grain, let's take wheat for
example, contains three parts:
- bran
- germ
- endosperm
The bran is the outer hard shell of
the grain. It is the part of the grain that provides the most fiber and most of
the B vitamins and minerals.
The germ is the next layer and is
packed with nutrients including essential fatty acids and vitamin E.
The endosperm is the soft part in
the center of the grain. It contains the starch. Whole grain means that the
entire grain kernel is in the food.
If you eat a whole grain food, it
contains the bran, germ, and endosperm so you get all of the nutrients that
whole grains have to offer. If you eat a refined grain food, it contains only
the endosperm or the starchy part so you miss out on a lot of vitamins and
minerals. Because whole grains contain the entire grain, they are much more
nutritious than refined grains.
Sugar is another type of
carbohydrate. You may also hear sugar referred to as simple or fast-acting
carbohydrate. There are two main types of sugar:
- naturally occurring sugars such as those in milk or fruit
- added sugars such as those added during processing such as fruit canned in heavy syrup or sugar added to make a cookie
On the nutrition facts label, the
number of sugar grams includes both added and natural sugars.
There are many different names for
sugar. Examples of common names are table sugar, brown sugar, molasses, honey,
beet sugar, cane sugar, confectioner's sugar, powdered sugar, raw sugar,
turbinado, maple syrup, high-fructose corn syrup, agave nectar, and sugar cane
syrup.
You may also see table sugar listed
by its chemical name, sucrose.
Fruit sugar is also known as fructose and the sugar in milk is called lactose.
You can recognize other sugars on labels because their chemical names also end
in "-ose." For example glucose (also called dextrose), fructose (also
called levulose), lactose, and maltose.
If you are looking for information
about artificial sweeteners, try this section.
Fiber comes from plant foods so
there is no fiber in animal products such as milk, eggs, meat, poultry, and fish.
Fiber is the indigestible part of
plant foods, including fruits, vegetables, whole grains, nuts, and legumes.
When you consume dietary fiber, most of it passes through the intestines and is
not digested.
For good health, adults need to try
to eat 25 to 30 grams of fiber each day. Most Americans do not consume nearly
enough fiber in their diet, so while it is wise to aim for this goal, any
increase in fiber in your diet can be beneficial. Most of us only get about ½
what is recommended.
Fiber contributes to digestive
health, helps to keep you regular and helps to make you feel full and satisfied
after eating. Additional health benefits, of a diet high in fiber — such as a
reduction in cholesterol levels — have been suggested by some so may be an
additional benefit.
Good sources of dietary fiber
include:
- Beans and legumes. Think black beans, kidney beans, pintos, chick peas (garbanzos), white beans, and lentils.
- Fruits and vegetables, especially those with edible skin (for example, apples, corn and beans) and those with edible seeds (for example, berries).
- Whole grains such as:
- Whole wheat pasta
- Whole grain cereals (Look for those with three grams of dietary fiber or more per serving, including those made from whole wheat, wheat bran, and oats.)
- Whole grain breads (To be a good source of fiber, one slice of bread should have at least three grams of fiber. Another good indication: look for breads where the first ingredient is a whole grain. For example, whole whe+at or oats.) Many grain products now have "double fiber" with extra fiber added.
- Nuts — try different kinds. Peanuts, walnuts and almonds are a good source of fiber and healthy fat, but watch portion sizes, because they also contain a lot of calories in a small amount.
In general, an excellent source of
fiber contains five grams or more per serving, while a good source of fiber
contains 2.5 - 4.9 grams per serving.
It is best to get your fiber from
food rather than taking a supplement. In addition to the fiber, these foods
have a wealth of nutrition, containing many important vitamins and minerals. In
fact, they may contain nutrients that haven't even been discovered yet!
It is also important that you
increase your fiber intake gradually, to prevent stomach irritation, and that
you increase your intake of water and other liquids, to prevent constipation.
Because fiber is not digested like
other carbohydrates, for carbohydrate counting purposes, if a serving of a food
contains more than or equal to 5 grams of dietary fiber, you can subtract half
the grams of dietary fiber from the total carbohydrate serving of that food.
A
Healthy Type 2 Diabetes Diet
Maintaining a healthy diet is
important for everyone, but it is especially important for people with
diabetes. A type 2 diabetes diet and following the right meal plan can make all
the difference to a person struggling to keep their blood sugar under control.
But, what is the right meal plan? How much of which food group should you eat?
Along with a visit to a dietician,
this guide should help answer questions you may have about diabetes and
nutrition.
Recommended Related to Diabetes
Because
type 2 diabetes can lead to serious health complications, it's important to be aware
of any diabetes warning signs and get tested for diabetes if you have these
symptoms. Treating diabetes early, when treatment is most effective, can help
prevent complications. We'll explain the various diabetes warning signs and
also warning signs of specific diabetes problems. Discover why it's important
to listen to your body and alert your doctor if you notice any new signs or
problems.
Carbohydrates
and Fiber in a Type 2 Diabetes Diet
Carbohydrates are one of the major
food categories (the others include proteins and fats) in a type 2 diabetes
diet. They provide fuel for the body in the form of glucose. Glucose is a sugar
that is the primary means of energy for all of the body's cells.
There are two ways to classify
carbohydrates -- simple and complex. Simple carbohydrates are sugars -- like
glucose, sucrose, lactose, and fructose. They are found in refined sugar and in
fruits. Complex carbohydrates are the starches, which are the simple sugars
bonded together chemically -- they are found in beans, nuts, vegetables, and
whole grains. Complex carbohydrates are considered healthier mostly because
they are digested by the body slowly, providing a steady source of energy. They
also contain valuable amounts of fiber.
Carbohydrates, rather than fats or
proteins, have the most immediate effect on your blood sugar since
carbohydrates are broken down directly into sugar early during digestion. It is
important to eat the suggested amount of carbohydrate at each meal, along with
some protein and fat.
Carbohydrates are mainly found in
the following food groups:
- Fruit
- Milk and yogurt
- Bread, cereal, rice, pasta
- Starchy vegetables like potatoes
What
Is Carbohydrate Counting?
Carbohydrate counting is a method of
meal planning that is a simple way to keep track of the amount of total
carbohydrates you eat each day. It helps allow you to eat what you want.
Counting grams of carbohydrate and evenly distributing them at meals will help
you control your blood sugar.
Instead of following an exchange
list, with carbohydrate counting you monitor how much carbohydrates (sugar and
starch) you eat daily. One carbohydrate serving is equal to 15 grams of
carbohydrates.
With carbohydrate counting, you plan
your carbohydrate intake based on what your pre-meal sugar is and your intake
or insulin dose can be adjusted. Carbohydrate counting can be used by anyone
and not just by people with diabetes that are taking insulin. If you eat more
carbohydrates than your insulin supply can handle, your blood sugar level goes
up. If you eat too little, your blood sugar level may fall too low. These
fluctuations can be managed by knowing how to count your carbohydrate intake.
A registered dietitian will help you
figure out a carbohydrate counting plan that meets your specific needs. For
adults, a typical plan generally includes three to four carbohydrates at each
meal, and one to two carbohydrate servings as snacks.
With carbohydrate counting, you can
pick almost any food product off the shelf, read the label, and use the
information about grams of carbohydrates to fit the food into your type 2
diabetes meal plan.
Carbohydrate counting is most useful
for people who take multiple daily injections of insulin, use the insulin pump,
or who want more flexibility and variety in their food choices. However, it may
not be for everyone, and the traditional method of following food exchange
lists may be used instead.
How
Much Fiber Should I Eat?
Fiber is the indigestible part of
plant foods. It plays an important role in the digestive process as it helps
move foods along the digestive tract, adding bulk to stool to help it pass
through the bowel. In addition, diets high in fiber are associated with lower risks
of obesity, high blood pressure, heart disease, and strokes.
Fiber also:
- Delays sugar absorption, helping to better control blood sugar levels.
- Binds with cholesterol and may reduce the level of 'bad' LDL cholesterol in the blood.
- Is a good source of vitamins and minerals.
- Helps prevent constipation and reduces the risk of certain intestinal disorders.
- Promotes weight loss by helping to decrease caloric intake. (It adds bulk to the food we eat, making you feel fuller.)
The goal for all Americans is to
consume 25 to 35 grams of fiber per day. The best way to increase fiber intake
as part of your type 2 diabetes diet is to eat more of these fiber-rich foods:
- Fresh fruits and vegetables
- Cooked dried beans and peas
- Whole grain breads, cereals, and crackers
- Brown rice
- Bran products
Fat
in a Type 2 Diabetes Diet
Since diabetes increases your risk
of developing heart disease, eating foods lower in fat -- especially saturated
fat -- is particularly important to keep that risk as low as possible. In
addition, limiting calories from fat can help you lose any extra weight,
especially when combined with an exercise program.
The major contributors of saturated
fats in our diet come from cheese, beef, milk, and baked items. Trans fats also
contribute to the increase risk of heart disease. These fats are vegetables
oils that are harder; we recognize these as solid oils. Many of these are used
in baking and frying.
Here are some general guidelines for
selecting and preparing low-fat foods for your type 2 diabetes diet:
- Select lean meats including poultry, fish, and lean red meats. When preparing these foods, don't fry them. Instead, you can bake, broil, grill, roast, or boil.
- Select low-fat dairy products such as low-fat cheese, skim milk, and products made from skim milk such as nonfat yogurt, nonfat frozen yogurt, evaporated skim milk, and buttermilk. Remember to include dairy products in your daily carbohydrate count.
- Use low-fat vegetable cooking spray when preparing foods or consider using cholesterol lowering margarine containing stanols or sterols. Examples include "Take Control" and "Benecol."
- Use liquid vegetable oils that contain poly- or monounsaturated fats which can help lower your 'bad' LDL cholesterol.
- Select lower fat margarines, gravies, and salad dressings and remember to watch the carbohydrate count on condiments and dressings.
- All fruits and vegetables are good low-fat choices. Remember to include fruit and starchy vegetables in your daily carbohydrate count.
Salt
in a Type 2 Diabetes Diet
Diabetes increases your risk for
high blood pressure. High levels of salt (sodium) in your diet can further
increase that risk. Your health care provider or dietitian may ask you to limit
or avoid these high-salt foods:
- Salt and seasoned salt (or salt seasonings)
- Boxed mixes of potatoes, rice, or pasta
- Canned meats
- Canned soups and vegetables (with salt)
- Cured or processed foods
- Ketchup, mustard, salad dressings, other spreads and canned sauces
- Packaged soups, gravies, or sauces
- Pickled foods
- Processed meats: lunch meat, sausage, bacon, and ham
- Olives
- Salty snack foods
- Monosodium glutamate or MSG
- Soy and steak sauces
Low-Salt
Cooking Tips
- Use fresh ingredients and/or foods with no salt added.
- For favorite recipes, you may need to use other ingredients and eliminate or decrease the salt you would normally add.
- Try orange or pineapple juice as a base for meat marinades.
- Avoid convenience foods such as canned soups, entrées, and vegetables; pasta and rice mixes; frozen dinners; instant cereal; and pudding, gravy, and sauce mixes.
- Select frozen entrées that contain 600 milligrams or less of salt. However, limit yourself to one of these frozen entrées per day. Check the Nutrition Facts label on the package for sodium content.
- Use fresh, frozen, no-added-salt canned vegetables, or canned vegetables that have been rinsed before they are prepared.
- Low-salt canned soups may be used.
- Avoid mixed seasonings and spice blends that include salt, such as garlic salt.
Thank you.
John
Cardinal
Copyright Healthy Weight Loss for
Life 2012
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