Melinda Maryniuk, MEd, RD, CDE
What is it?
Carbohydrate (or carb) counting is a method of meal planning where you keep track of the grams of carbs you eat at each meal and snack. There are two ways to carb count…
- Option 1: Consistent. This method is recommended for people who take the same dose of their diabetes medicine every day. Consistent carb counters aim to eat the same amount of carbs at each meal and snack. The amount of diabetes medicine taken (some types of insulin, pills or a GLP-1 injectable) stays the same.
- Option 2: This method is recommended for people who take rapid acting insulin before each meal or use an insulin pump. The amount of insulin taken is flexible, and varies based on the amount of carb eaten at each meal or snack (which is also flexible). It also requires knowing your own “carb-insulin-ratio,” which can be determined by your physician, diabetes care and education specialist or dietitian. (This isn’t something that’s going to be covered in this article so be sure to talk with your healthcare team about what’s right for you.)
Do I have to carb count?
Not necessarily. While everyone with diabetes should be aware of which foods contain carbs, precise carb counting is especially recommended for people on flexible insulin regimens who take rapid acting insulin before each meal.
Most people with type 2 diabetes who take the same amount of diabetes medicine every day do well using the plate method. With the plate method, carbs are controlled by limiting foods that are higher in carbs (such as potatoes, corn, rice or pasta) to ¼ of the plate and sometimes, including one carb side dish (such as fruit, milk or yogurt).
Which foods contain carb?
The following foods contain carbs. Some foods with carbs also contain protein and fat.
- Starches, including
- Breads, tortillas, and cereals
- Pasta, rich and grains
- Beans, peas and lentils
- Starchy vegetables such as potatoes, corn and peas
- Crackers, pretzels and chips
- Fruits and juices
- Milk, milk alternatives and yogurt
- Non-starchy vegetables such as broccoli, green beans, carrots, asparagus, and salad greens (but these have very small amounts of carbs)
- Sweets and desserts.
- Many processed and prepared foods. Read the label!
How many carbs do I need?
A dietitian can help you determine a target amount of carbs based on your usual eating habits, weight, activity level, blood glucose patterns, and your diabetes medicines. However, until you see a dietitian, you can use this handy guide as a starting point. Take a look at the two examples below to see how it works.
Meal Carbohydrate Guidelines: Getting Started
|Male and not overweight||4-5 carb servings (60-75 grams carb)|
|Female and not overweight||3-4 carb servings (45-60 grams carb)|
|Overweight (>10 pounds)||Subtract 1 carb serving (15 grams carb)|
|Exercise regularly (3-5 x/week)||Add one carb serving (15 grams carb)|
|Snacks||1-2 carb servings (15-30 grams carb)|
Mary is working hard to lose some excess weight. She eats a similar quantity of food at lunch and supper, but is usually not hungry for much at breakfast. She is not engaging in any exercise at this time but she wants to plan for an occasional snack. The recommendation for her would be as follows:
Breakfast: 15-30 grams of carbs (1-2 servings)
Lunch: 30-45 grams of carbs (2-3 servings)
Dinner: 30-45 grams of carbs (2-3 servings)
Snack: 15 grams of carbs
John is comfortable with his present weight and is not trying to lose weight. He eats a small breakfast and a large mid-day meal. He walks a few times a week, and enjoys having an evening snack. This is the pattern that is working for him:
Breakfast: 30-45 grams of carbs (2-3 servings)
Lunch: 75-90 grams of carbs (5-6 servings)
Dinner: 60-75 grams of carbs (4-5 servings)
Snack: 30 grams of carbs on days he takes a long walk; 15 grams on other days.
The best way to know if your carb budget is right for you is to monitor both your weight and your blood glucose. Check blood glucose at the beginning of the meal and 2 hours after the start of the meal to see if you are in your target range, which for most people, is less than 180 mg / dl, although you’ll want to talk to your doctor to see what’s right for you.
Carb servings? Carb grams?
In carb counting terms – you may hear people refer to “carb servings” or “carb choices.” Lists of foods containing carbs are written so that each food in a specific portion size contains about 15 grams of carbs. This is a great way to estimate the amount of carbs in commonly eaten foods instead of having to look everything up.
For example, each of these foods contains 15 grams of carbs:
|1 slice (1 oz) bread||½ cup oatmeal||1 small apple (4 oz)|
|½ cup cooked pasta||¾ cup unsweetened cereal||17 small grapes (3 oz)|
|1/3 cup cooked rice||6 saltine crackers||1 cup milk (8 oz)|
|½ cup corn||½ cup cooked beans, peas, lentils||2 small cookies (2 ½ inch diam)|
Keep in mind that lists like these are just to help you estimate the amount of carbs in a meal – it does not mean you are limited to this amount. For example, if you want to use your full meal budget of 45 grams of carbs on rice, you would eat 1 cup rice.
All of the options below contain 45 grams of carbs… except one. Which one is not 45 grams? (see answer at the bottom).
- ½ cup cooked pasta, 1 cup kidney beans
- 1 cup corn, 1 small apple
- 1 1/2 cup unsweetened cereal, ½ cup milk, ½ small apple
- 2 small cookies, 4 crackers, 1 slice bread
How do I get started?
Now that you know your target goal for carbs at each meal, you can start counting. Having these carb-counting resources is helpful:
- Measuring equipment: In order to be accurate, you’ll need to use your measuring cups, spoons and a food scale. It is recommended you measure all foods containing carbs for the first few weeks to improve your skills. With practice, you’ll become good at estimating, but it is recommended that once a month you check yourself over a few days to make sure your serving sizes are on target.
- Carb counting books or apps: Choose what works best for you. There are lots of paper or digital options available. Popular choices include Calorie King and My Fitness Pal. Some digital apps (like My Fitness Pal) also have the ability to scan a food item so you can see the nutrition information right away instead of searching for it on a label.
- Food lists: Use the Diabetes- What To Know food list as a great starting point to learn 15 gram carb portion sizes.
- Food labels: Get used to reading the labels of the foods you commonly eat. You’ll find differences in the number of carbs from different brands from the estimated carb levels on the food lists. For example:
- Dave’s Killer Power Seed Bread: 18 g carbs
- Dave’s Killer Thin Sliced Power Seed Bread: 12 g carbs
Where do I focus on the food label?
While the nutrition facts panel has a lot of information on it – you really only need to focus on two things:
- Serving size – Check both the serving size as well as the servings per container. If there are 2 servings in a package and you eat the whole package, then you have eaten 2 servings. The nutrition facts are given in relation to the serving size listed – so if you eat 2 servings, you need to double the numbers (such as calories and grams of carbs).
- Total Carbohydrate – This reflects the number of grams of all types of carbs in one serving. No need to get distracted by the grams of sugar; keep your eye on the total carbs as this number includes the total sugars, added sugars and dietary fiber.
- Rich in Fiber – this is a health bonus! If you have a choice, choose the item containing more fiber. A product is a good source of fiber if it has 3 grams or more per serving.
- Low in saturated and trans fats. Choose foods that have zero trans fats and are low in saturated fat.
What about protein and fat? Do I need to count them?
As a general rule, aim to eat lean sources of protein (fish, poultry, lean beef, tofu, beans, nuts) and limit the amount of saturated and trans fats. You don’t need to count them though. Protein and fat have limited effect on blood glucose, especially if you eat them in consistent amounts each day (by using the plate method!)
What else do I need to know?
- Carb counting is not an exact science. If you’re going for consistent carb counting, aim for target ranges – not a specific number.
- Carb counting is only as accurate as your portion size estimates are. If you think you’ve been drinking ½ cup juice but you’ve never really measured it … you could be getting far more carbs than you realize.
- Quality is as important as quantity. Aim to choose foods that are wholesome and minimally processed. Minimize the foods you eat that are made from refined, white flour. Sure, you can count 45 grams of carb from a highly processed fruit drink or chips, but the overall health value of whole foods is better for you, your weight and your diabetes.
- Memorize the 15 gram carb servings of your favorite foods. It will make it easier to estimate the amount of carbs you’re eating.
- Remember that carbs are not only in foods – but also in many drinks, including milk and fruit juices. It’s best to avoid sugar sweetened beverages and fruit drinks altogether, and be sure to check the number of carbs in alcoholic beverages such as beer and mixed drinks.
- Create your personal food lists. Keep track of the carb content of the foods you commonly eat so you don’t have to look it up every time.
- It’s true that non-starchy vegetables contain some carb – but not much. Generally, we don’t eat them in large enough quantities to add up to much. As a general guide, it’s not recommended to count carbs in veggies like broccoli, spinach, asparagus, tomatoes… just aim to fill half your plate with them.
- Do bring out the measuring cups from time to time. It’s easy to under- or overestimate the amount of food you’re eating.
- Mark a few dishes with a piece of tape so you know the line for an 8oz glass of milk, a 4oz glass of juice or the amount of cereal that is your carb budget for that item.
Bottom line – if you are learning about consistent carb counting to help control your overall carb intake, don’t be too hard on yourself and don’t sweat the small stuff. Take it gradually. Start by counting the carbs in the foods or beverages you most commonly consume that contain largest amounts of carbs. Keep a log of what you’re eating, the number of carbs you estimate you’ve eaten, as well as your blood glucose numbers. Paired checking is a great way to evaluate if the amount of carbs you’re eating is right for you. Good luck!!
POP QUIZ ANSWER:
It is less than 45 grams by a little, because the serving of crackers is 4 instead of 6.
If you liked this article, learn more about ways to eat healthier with diabetes here.