Category Archives: Diabetes

Diabetes and Carbohydrate Counting

carbohydrate countingWorld Diabetes Day is the primary global awareness campaign for diabetes and is held on November 14 each year. It was introduced in 1991 by the International Diabetes Federation and the World Health Organization in response to the alarming rise of diabetes around the world. There were 62 million diabetics in India in 2014, according to CDC, which is equivalent to Italy’s population. We all know that lifestyle modification is the key to prevent this disease, but those who are already suffering with it can resort to carbohydrate counting to keep the diabetes related complications at bay.

Carbohydrate counting is a meal planning tool for people with diabetes. It involves keeping track of the amount of carbohydrate in the foods we eat each day. Carbohydrates are one of the main nutrients found in food and drinks; protein and fat being the other two. Carbohydrate counting can help a person in controlling blood sugar levels because carbohydrates affect blood glucose more than other nutrients. The amount of carbohydrate in foods is measured in grams. To count grams of carbohydrate in foods you eat, you will need to

  • know which foods contain carbohydrates
  • learn to estimate the number of grams of carbohydrate in the foods you eat
  • add up the number of grams of carbohydrate from each food you eat to get your total for the day

Foods that contain carbohydrates

  • grains, such as bread, noodles, pasta, breakfast cereals, rice, wheat
  • fruits, such as apples, bananas, mangoes, melons, and oranges
  • milk and other dairy products
  • legumes, lentils, and peas
  • snack foods and sweets, such as cakes, cookies, candies, and other desserts
  • juices, soft drinks, fruit drinks, sports drinks and other energy drinks that contain sugars
  • vegetables, especially “starchy” vegetables such as potatoes, corn, colocasia (arbi), sweet potato, yam (zimikand) and peas

How much carbohydrate do I need each day?

The daily amount of carbohydrate, protein, and fat for people with diabetes has not been defined—what is best for one person may not be good for another. Everyone needs to get enough carbohydrate to meet the body’s needs for energy, vitamins, minerals and fiber. Experts suggest that carbohydrate intake for most people should be between 45 and 65% of total calories.

One gram of carbohydrate provides about 4 calories, so you will have to divide the number of calories you want to get from carbohydrates by 4 to get the number of grams. For example, if you are required to eat 1,500 calories per day and get 50% of your calories from carbohydrates, you would calculate the required carbohydrate amount as follows:

  • 50 x 1,500 calories = 750 calories
  • 750 ÷ 4 = 187.5 grams of carbohydrate

You then need to divide these 190 g throughout the day. A dietician or diabetes educator can help you learn what foods to eat, how much to eat, and when to eat based on your weight, activity level, medicines, and blood glucose targets.

How to find out carbohydrate content of foods you eat?

You will need to learn to estimate the amount of carbohydrate in foods you typically eat. For example, the following amounts of carbohydrate-rich foods each contain about 15 grams of carbohydrate:

  • 1 slice of bread
  • 1/3rd cup of pasta / rice
  • ½ cup of canned or fresh fruit or fruit juice or one small piece of fresh fruit, such as a small apple or orange
  • ½ cup of starchy vegetables such as mashed potatoes, cooked corn, peas, or beans
  • ¾ cup of dry cereal or ½ cup cooked cereal

Some foods are so low in carbohydrates that you may not have to count them unless you eat large amounts e.g. most non-starchy vegetables are low in carbohydrates. A ½ cup serving of cooked non-starchy vegetables or a cup of raw vegetables has only about 5 grams of carbohydrate. Also you can find out how many grams of carbohydrate are in the foods you eat by checking the nutrition labels on food packages. You can use books or websites that list the carbohydrate content of food items to estimate the amount of carbohydrate in a serving.

How to know whether carbohydrate counting is working for you or not?

Checking blood glucose levels regularly can help you in knowing whether carbohydrate counting is working for you. You should also have an HbA1C blood (glycosylated haemoglobin) test at least twice a year. This test reflects the average amount of glucose in your blood during the past 3 months. If the blood glucose levels are too high, you may need to make wiser food choices, be more physically active, or make changes to your diabetes medicines.

More help with carbohydrate counting

The Internet has carbohydrate counting tools that let you enter a type of food and find out what nutrients the food contains, including carbohydrates. Try visiting these sites:

Fibre: Benefits and how to Increase its amount in your diet

Eat more fibre. You have probably heard it before. But do you know why fibre is so good for your health?
Fibre — found mainly in fruits, vegetables and whole grains is probably best known for its ability to prevent or relieve constipation. But foods containing fibre can provide other health benefits as well, such as helping to maintain a healthy weight and lowering the risk of diabetes and heart disease. Dietary fibre includes all parts of plant foods that our body cannot digest or absorb. Instead, it passes relatively intact through the digestive system and passes out of the body.
A high-fibre diet:
• Normalizes bowel movement: Fibre increases the weight and size of stool and softens it. A bulky stool is easier to pass, decreasing the chance of constipation.
• Helps maintain bowel health: A high-fibre diet may lower the risk of developing haemorrhoids (piles) and other intestinal disorders.
• Lowers cholesterol levels: Soluble fibre found in beans, oats, flaxseed and oat bran may help lower low-density lipoprotein (LDL) cholesterol levels. Studies also have shown that fibre may have other heart-health benefits, such as reducing blood pressure.
• Helps control blood sugar levels: In people with diabetes, fibre can slow the absorption of sugar and help improve blood sugar levels. A healthy diet that includes fibre may also reduce the risk of developing type 2 diabetes.
• Aids in achieving healthy weight: High-fibre foods generally require more chewing time, which gives the body time to register that I am not hungry anymore, so less chances of overeating. Plus you feel full for a longer duration after eating high fibre foods and meals high in fibre are usually low in calories. So you end up consuming lesser calories.
How much fibre do you need each day?
The amount of fibre a person needs depends on the age and gender. Men 50 years of age and younger should consume at least 38 g of fibre / day, while older than 50 years should aim for at least 30 g of fibre daily. Women of 50 years or younger should consume at least 25 g of fibre / day, while older than 50 years should aim for at least 21 g of fibre daily. (Institute of Medicine, 2012)
Try the following ideas to increase the fibre in your diet:
1. Eat at least 2 cups of fruits and 2½ cups of vegetables each day. Fruits and vegetables that are high in fibre include: pears, green peas, berries, prunes, figs, dates, spinach, apples, oranges, beans like kidney beans (rajmah) to name a few.
2. Replace refined white bread with whole-grain breads and cereals. Eat brown rice instead of white rice. Add wheat bran to flour while making dough for chappati. Eat more of foods like oatmeal, bran or multiple-grain cereals, cooked or dry.
3. When purchasing foods from store, check the nutrition information labels for the amounts of dietary fibre in each product. Aim for 2-5 g fibre / serving.
4. For breakfast choose a high-fibre breakfast cereal. Opt for cereals which say ‘whole grain’, ‘bran’ or ‘fibre’ in the name.
5. Fresh fruits, raw vegetables and whole-grain crackers are all good options for high fibre snacks. An occasional handful of nuts or dried fruits also is a healthy, high-fibre snack — although be aware that nuts and dried fruits are high in calories.
High-fibre foods are good for health but adding too much fibre too quickly can promote gas, bloating and cramping. Fibre should be increased gradually over a period of a few weeks. This allows the digestive system to adjust to the change. Also, drink plenty of water (min. 8 glasses / day) as fibre works best when it absorbs water.