Diabetes: Watching Your Carbs

If you have diabetes, carbohydrates can be the most confusing part of your menu. Carbs raise your blood sugar, but they also provide much-needed energy. Eating too many carbs can make you gain weight, but skimping on them means you miss out on the fiber and nutrients found in many carbohydrate-rich foods.

To make things even more complicated, some carbohydrates raise blood sugar faster and higher than others. Fortunately, you don't need a degree in nutrition to manage all this. By keeping a few simple things in mind, you can enjoy the benefits of carbs without losing control of your diabetes.

The first thing to know is that you need plenty of carbohydrates every day. So-called "low-carb" diets won't give you the energy and nutrition you need to feel your best. The American Diabetes Association and other groups recommend getting 45 percent to 65 percent of all calories from carbohydrates. If you're counting carb grams, you should shoot for about 45 to 60 grams of carbohydrates at every meal if you're a woman, 60 to 75 if you're a man.

How does that translate on the plate? You could get 60 grams from a single large baked potato. For a little more variety, 1/3 of a cup of pasta, a small piece of fruit, two small cookies, and a slice of bread also add up to 60 grams of carbs.

The next thing to remember is that not all carbs are alike. Nutritionists used to talk about "simple carbs" and "complex carbs," but those labels didn't stick. Today, experts sort carbs by how they affect blood sugar. In general, the easier a food is to digest, the more it will raise blood sugar. For example, a piece of white bread will spike blood sugar more than whole grain bread, mainly because the extra fiber in the whole flour makes it harder to digest.

Foods that raise blood sugar the most include white bread, white rice, white flour pasta, refined breakfast cereals (such as corn flakes), doughnuts, crackers, and potatoes. In medical speak, these foods are said to have a "high glycemic load. Carbohydrate choices with a low glycemic load -- those that raise blood sugar the least -- include beans, non-starchy vegetables, bran cereal, and most kinds of fruit. Foods with a moderate glycemic load -- those that raise blood sugar a medium amount -- include whole grain breads, whole wheat pasta, brown rice, and fruit juice with no added sugar.

Some nutritionists recommend keeping track of the glycemic load for each meal. To make this possible, they have assigned a score called a glycemic index to just about every type of food that contains carbohydrates. In theory, you could use such a score sheet to fine-tune every meal. But such an approach isn't easy, and it isn't foolproof. The glycemic index of a particular food can change depending on how it's served. For example, a baked potato has a lower score than mashed potatoes. A hard peach or plum has a lower score than a ripe, mushy piece of fruit. Surprisingly, some decidedly non-healthy foods -- such as a Snickers bar -- actually have low glycemic scores.

Adding healthy carbohydrates to your diet doesn't have to be so complicated. Instead of worrying about glycemic scores, you could simply make a point of eating more whole grain foods, fruits, vegetables, and beans and less white bread, regular pasta, potatoes, and heavily processed foods. Not only will you have an easier time keeping your blood sugar under control, you'll also be benefiting from the extra fiber and nutrients that go along with healthy carbohydrates.

References

American Diabetes Association. Glycemic index and diabetes. http://www.diabetes.org/food-nutrition-lifestyle/nutrition/meal-planning/glycemic-index-and-diabetes.jsp

Harvard School of Public Health. Carbohydrates: Good carbs guide the way. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/carbohydrates-full-story/index.html

American Diabetes Association. Dietary carbohydrate (amount and type) in the prevention and management of diabetes.

Drago L et al. Diabetes and nutrition: Carbohydrates. The Journal of Clinical Endocrinology and Metabolism. 93(30). http://jcem.endojournals.org/cgi/content/full/93/3/0

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