UNIT THREE LESSON 8Carbohydrate Counting

ObjectivesAt the end of the lesson, participants should be able to:

1. Describe carbohydrate counting

2. Explain the role of counting carbohydrates in the management of diabetes

3. Name foods high and low in carbohydrates

4. Choose to set or revise goals that relate to carbohydrate counting

5. Describe feelings and experiences of eating with diabetes

6. Identify ways to modify everyday recipes to fit into the diabetes meal plan

L-esson

Meal PlanningPlanning your food intake is the first step in controlling

your blood glucose and diabetes

When you eat healthy, you feel better

Your family will also eat better and learn good eating habits for life

Meal PlanningBefore you begin counting carbohydrates, you should

meet with a registered dietitian to develop a meal plan that is right for you

Carbohydrate CountingCarbohydrate counting is a way of keeping track of the

amount of carbohydrates you get from the foods you eat

This is done to manage your blood glucose level

Carbohydrate CountingCarbohydrates are found in the following foods:

Fruit and juiceStarchy foods: bread, pasta, cereal, rice, crackersStarchy vegetables: corn, potatoes, squash, yamsDried beans and peasMilk and yogurtSweets and snack foods: cake, cookies, candy, soda

Carbohydrate CountingFoods are a combination of protein, fat, and

carbohydrate

Foods that contain carbohydrate (sugars and starches) have the greatest effect on blood glucose

Carbohydrate CountingWhen carbohydrate foods are eaten, they are

changed almost completely to glucose after about 90 minutes

Fats and protein do not raise blood glucose, but a person with diabetes should limit his or her intake of fats

Benefits of Carbohydrate Counting

Allows you to spread carbohydrate intake across the day

Can help you manage your weightEating too many carbs can lead to weight gain

Keeps blood glucose level within the target range

Steps in Carbohydrate Counting

1. Know the foods that contain carbohydratesBreads, crackers, cereals, biscuits, pastaGrains, rice, corn, wheat, oats, couscousStarchy vegetables—potatoes, corn, peas, winter squash,

pumpkinFruits (fresh, canned, dried) and fruit juicesMilk, yogurtSweets, desserts

Steps in Carbohydrate Counting

2. Know what counts as a serving sizeCheck serving size with measuring cups and spoons or a

food scale

Read the Nutrition Facts on food labels to find out how many grams or carbohydrate are in the foods you eat

Serving Sizesof Carbohydrate Foods

Breads and grains Pasta (cooked): 1/3 cup

Bagel: ¼ of a large (1 ounce)

Biscuit: 1 whole

Bread: 1 slice

Cereal (cooked): ½ cup

Cereal (ready-to-eat): ¼ cup

Crackers (saltines): 6

Rice: 1/3 cup

Hamburger bun: ½ bun

Taco shells: 2 (6-inch)

Tortillas: 1 (6-inch)

Starchy Vegetables Peas: ½ cup

Pinto or kidney beans: ½ cup

Corn: ½ cup

Potato, mashed: ½ cup

Sweet potato: ½ cup

Serving Sizes ofCarbohydrate Foods

Fruit Apple: 1 small (4 ounces) Banana: 1 small (4 ounces) Peach: 1 medium (4 ounces) Orange juice: ½ cup Fruit, canned: ½ cup

Milk Milk: 1 cup Yogurt: 2/3 cup plain, fat-free

or sweetened with sugar substitutes

Dessert Cake (unfrosted): 2 inch Cookies: 2 small Ice cream (light): ½ cup

Snack Popcorn: 3 cups popped Potato chips: ¾ ounce (15-20 chips) Pretzels: ¾ ounce

Others Sugar: 1 tablespoon Jelly or jam: 1 tablespoon

Examples of Portion SizesFood Group Portion Estimate

Meat, fish, poultry, meat substitutes

3 ounces The area of palm of the hand(not including the fingers) and the thickness of the little finger

Grains and starchy vegetables

1 cup(2 servings)

Closed fist

Fruit 1 serving Closed fist

Vegetables (non-starchy)

1 serving Both hands cupped together

Milk 8 ounces 8 ounce glass or mini soda can

Cheese 1 ounce Thumb

Mayonnaise or Margarine

1 teaspoon Thumb tip

Steps in Carbohydrate Counting

3. Know that one serving of carbohydrate food

equals 15 grams

Steps in Carbohydrate Counting

4. Know the foods that are considered “free” Foods that contain non calorie sweeteners or sugar

substitutes:Sugar-free soft drinks

Unsweetened tea or coffee (no milk added)

Gelatin

Broth

Foods that contain: less than 20 calories per serving or

5 grams of carbohydrates

Steps in Carbohydrate Counting

Foods that are considered “free”Raw vegetables: count up to 1 cup of raw cooked non-

starchy vegetables or ½ cup cooked non-starchy vegetables as “free” foods

However, three or more servings of non-starchy vegetables at one meal counts as one carbohydrate serving

For example, 1 ½ cups cooked carrots at one meals counts as one carbohydrate serving

Steps in Carbohydrate Counting

5. One serving of combination foods such as pizza, casseroles, and soups should be counted as two carbohydrate servings

Carbohydrate Measurements

Carbohydrates are measured in grams

One carbohydrate serving =

15 grams of carbohydrates

• Check the nutrition fact panel of food labels to see the grams of carbohydrate in food

Using Food LabelsThe two most

important areas of the food labels in terms of carbohydrate counting are:Serving SizeTotal Carbohydrate

Let’s Practice

If you had one large bagel for breakfast, how many carbohydrate servings did you have?

Let’s Practice

If you had one hamburger for lunch, how many carbohydrate servings did you have?

Let’s PracticeIf you had 1 cup of

mashed potatoes for dinner, how many carbohydrate servings did you have?

Let’s Practice

If you had three cups of popcorn as a snack, how many carbohydrate servings did you have?

Serving SizeServing size tells you what is considered a serving for a

particular food.

If you are eating twice or three times the amount of the serving size on the food package, then you have to double or triple the amount of total carbohydrates and other information on the label.

Total Carbohydrateson the Food Label

Rules for Carbohydrate Counting

Number of grams Number of servings

0 – 5 grams Do not count

6 – 10 grams ½ carbohydrate serving or ½ starch, fruit, or milk serving

11 – 20 grams 1 carbohydrate serving or 1 starch, fruit, or milk serving

21 – 25 grams 1 ½ carbohydrate servings or 1 ½ starch, fruit, or milk servings

26 – 35 grams 2 carbohydrate servings or 2 starch, fruit, or milk servings

Other Parts of the Food Labelto Consider

Individuals with diabetes are more likely to develop heart disease

Look out for saturated fat and trans fatChoose foods that are low in saturated and trans fats to

lower your risk for heart disease

Other Parts of the Food Labelto Consider

Individuals with diabetes are more likely to develop high blood pressure

Look out for sodiumChoose foods that are low in sodium

When Counting Carbohydrates

Keep a record of the food you eat and your blood glucose levelsThis can help you understand which foods are more likely

to cause your blood glucose level to rise quickly

Check your blood glucose level regularlyThis can tell you if you need to adjust the timing of your

meals

Meal Planning TipsThe number of servings of

carbohydrates you should eat varies depending on:Weight

Level of physical activity

Diabetes medication

Goals set by your doctor for blood glucose control

Meal Planning TipsThe American Dietetic Association suggests for many

adults:

Three to five servings of carbohydrate foods at each meal and

One or two carbohydrate servings for each snack

Meal Planning TipsMost people will plan to eat three to five carbohydrate

servings at each mealWomen generally need about three to four

carbohydrate servings at each mealMen generally need four to five carbohydrate

servings at each mealAllow one to two servings for each snack

Meal Planning TipsUse mostly whole-grain products, such as whole wheat

bread, oatmeal, brown rice, and whole-grain cereals

Eat four to six ounces of lean meat or other protein foods each day

Use healthy fats, such as olive oil and canola oil, in salad dressings and for cooking

Eat as little trans fat as possible and keep saturated fat low

Sample MenuBreakfast

One small orange (one carbohydrate serving)

½ cup shredded wheat cereal (one carbohydrate serving)

One cup fat-free or low-fat milk (one carbohydrate serving)

½ English muffin with 1 teaspoon soft margarine (one carbohydrate serving)

Sample MenuLunch

Sandwich Two slices of whole-wheat bread (two carbohydrate servings) Two ounces of lean meat

Vegetables: Three to four carrot sticks, three to four celery sticks, two lettuce leaves

One cup fat-free or low-fat milk (one carbohydrate serving)

Snack

1/2 cup canned fruit in its own juice (one carbohydrate serving)

3/4 ounce unsalted mini-pretzels (one carbohydrate serving)

Sample MenuDinner

Three ounces grilled chicken breast

1/3 cup cooked pasta (one carbohydrate serving)

½ cup green beans

One small whole wheat dinner roll (one carbohydrate serving)

One cup melon balls (one carbohydrate serving)

Ice tea sweetened with sugar-free sweetener

Snack

Six ounces of low-fat, fruited yogurt with sugar-free sweetener (one carbohydrate serving)

Two tablespoons unsalted nuts

E-mpowermentDiabetes Education Series: Carbohydrate Counting

Diabetes Education SeriesDescribe your experiences of eating related to

diabetes.

What was most difficult for you?

What are ways that you could overcome some of these difficulties?

A-ctionDid you accomplish the goal you set last week?

Set a goal to practice carbohydrate counting

R-eal-Life Problem SolvingDuncan’s Story

Duncan’s Story

Questions aboutDuncan’s Story

What is Duncan’s problem?

What suggestions do you have for Duncan in the area of carbohydrate counting?

What is the best advice you can give to Duncan in this situation and why?

What would you do if you were in Duncan’s situation?

Questions aboutDuncan’s Story

Please find the Real-Life Problem Solving handout for this lesson in your folder

These questions will help with your understanding of Duncan’s story

NutritionMenu

Baked ChickenRed Potato Salad

All Season Refresher

See you next week!Keep moving on!

Topic for the next week:

Think Your Plate

Date:

References:

Margaret E. Cook-Newell, Ph.D., R.D., L.D., CDE Irene Hong-McAtee, MD, MCR

Adrienne Glodt, B.S., Graduate Student Laura Hieronymus, MSEd, APRN, BC-ADM, CDE Cheryl Case, M.S., Harrison County Ann Hollon, M.A., Wolfe County 

Hazel Forsythe, Ph.D., R.D., L.D., CFCS Stephen D. Perry, M.S., R.D., L.D. Pam Sigler, M.S. Lynn Blankenship, M.S., Metcalfe County Theresa Scott, M.A., Floyd County Tamara Thomas, M.S., Franklin County

Rusty Manseau, B.A., Graphic Artist

Author: Ingrid Adams, Ph.D., Assistant Professor , Nutrition and Food Science, University of Kentucky

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