Transcript taking ownership of your diabetes

UNIT THREE LESSON 8
Carbohydrate Counting
Objectives
At the end of the lesson, participants should be able to:
1. Describe carbohydrate counting
2. Explain the role of counting carbohydrates in the
3.
4.
5.
6.
management of diabetes
Name foods high and low in carbohydrates
Choose to set or revise goals that relate to carbohydrate
counting
Describe feelings and experiences of eating with diabetes
Identify ways to modify everyday recipes to fit into the
diabetes meal plan
L-esson
Meal Planning
 Planning 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 Planning
 Before you begin counting carbohydrates, you should
meet with a registered dietitian to develop a meal plan
that is right for you
Carbohydrate Counting
 Carbohydrate 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 Counting
 Carbohydrates are found in the following foods:
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Fruit and juice
Starchy foods: bread, pasta, cereal, rice, crackers
Starchy vegetables: corn, potatoes, squash, yams
Dried beans and peas
Milk and yogurt
Sweets and snack foods: cake, cookies, candy, soda
Carbohydrate Counting
 Foods are a combination of protein, fat, and
carbohydrate
 Foods that contain carbohydrate (sugars and starches)
have the greatest effect on blood glucose
Carbohydrate Counting
 When 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 weight
 Eating 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 carbohydrates
 Breads, crackers, cereals, biscuits, pasta
 Grains, rice, corn, wheat, oats, couscous
 Starchy vegetables—potatoes, corn, peas, winter squash,
pumpkin
 Fruits (fresh, canned, dried) and fruit juices
 Milk, yogurt
 Sweets, desserts
Steps in Carbohydrate
Counting
2. Know what counts as a serving size
 Check 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 Sizes
of Carbohydrate Foods
 Breads and grains
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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
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Peas: ½ cup
Pinto or kidney beans: ½ cup
Corn: ½ cup
Potato, mashed: ½ cup
Sweet potato: ½ cup
Serving Sizes of
Carbohydrate Foods
 Fruit
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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
 Dessert
 Cake (unfrosted): 2 inch
 Cookies: 2 small
 Ice cream (light): ½ cup
 Snack
 Popcorn: 3 cups popped
 Potato chips: ¾ ounce
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(15-20 chips)
 Pretzels: ¾ ounce
or sweetened with sugar
substitutes
 Others
 Sugar: 1 tablespoon
 Jelly or jam: 1 tablespoon
Examples of Portion Sizes
Food 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 (nonstarchy)
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:
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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 nonstarchy 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 Labels
 The two most
important areas of
the food labels in
terms of
carbohydrate
counting are:
 Serving Size
 Total 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 Practice
 If 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 Size
 Serving 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 Carbohydrates
on 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 Label
to Consider
 Individuals with diabetes are more likely to develop
heart disease
 Look out for saturated fat and trans fat
 Choose foods that are low in saturated and trans fats to
lower your risk for heart disease
Other Parts of the Food Label
to Consider
 Individuals with diabetes are more likely to develop
high blood pressure
 Look out for sodium
 Choose foods that are low in sodium
When Counting
Carbohydrates
 Keep a record of the food you eat and your blood
glucose levels
 This can help you understand which foods are more likely
to cause your blood glucose level to rise quickly
 Check your blood glucose level regularly
 This can tell you if you need to adjust the timing of your
meals
Meal Planning Tips
 The 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 Tips
The 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 Tips
 Most people will plan to eat three to five carbohydrate
servings at each meal
 Women generally need about three to four
carbohydrate servings at each meal
 Men generally need four to five carbohydrate
servings at each meal
 Allow one to two servings for each snack
Meal Planning Tips
 Use 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 Menu
Breakfast
 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 Menu
Lunch
 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 Menu
Dinner
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Three ounces grilled chicken breast
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1/3 cup cooked pasta (one carbohydrate serving)
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½ cup green beans
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One small whole wheat dinner roll (one carbohydrate serving)
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One cup melon balls (one carbohydrate serving)
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Ice tea sweetened with sugar-free sweetener
Snack
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Six ounces of low-fat, fruited yogurt with sugar-free sweetener (one carbohydrate serving)
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Two tablespoons unsalted nuts
E-mpowerment
Diabetes Education Series: Carbohydrate Counting
Diabetes Education Series
 Describe 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-ction
Did you accomplish the goal you set last week?
Set a goal to practice carbohydrate counting
R-eal-Life Problem Solving
Duncan’s Story
Duncan’s Story
Questions about
Duncan’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 about
Duncan’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
Nutrition
Menu
Baked Chicken
Red Potato Salad
All Season Refresher
See you next week!
Keep moving on!
Topic for the next week:
Think Your Plate
Author: Ingrid Adams, Ph.D., Assistant Professor , Nutrition and
Food Science, University of Kentucky
Other Contributors
Margaret E. Cook-Newell, Ph.D., R.D., L.D., CDE
Irene Hong-McAtee, MD, MCR
Adrienne Glodt, B.S., Graduate Student
Date:
Hazel Forsythe, Ph.D., R.D., L.D., CFCS
Stephen D. Perry, M.S., R.D., L.D.
References:
Pam Sigler, M.S.
Laura Hieronymus, MSEd, APRN, BC-ADM, CDE
Lynn Blankenship, M.S., Metcalfe County
Cheryl Case, M.S., Harrison County
Theresa Scott, M.A., Floyd County
Ann Hollon, M.A., Wolfe County
Tamara Thomas, M.S., Franklin County
Rusty Manseau, B.A., Graphic Artist