Instructions
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Sample Diet Plan Calculations
A quick calculation using round numbers may help to see where we are going with this: In the United States all packaged foods are required to have a ‘Nutrition Facts’ food label—you’re probably familiar with them. They tell the nutritional content and serving size of the food. If we use the “daily value” diet that you see on these food labels (remembering that this is not for everyone, it is only an example) we can start with 2000 calories. Let’s say we want to go with about half of those calories as carbohydrates. That gives us 1000 calories of carbs to work with. Because carbohydrates give us about 4 calories per gram, we can divide the 1000 calories to get the amount of carbs that we would recommend for this balanced diet as 250 grams (100/4=250).
If we say that a carb serving is 15 grams, then we can divide the 250 grams to give us about 17 carb servings per day. The actual number is 16.67, but it might be kind of difficult for many patients to worry about and master that 2/3 of a carb serving.
The next thing we want to do is to distribute these throughout the day. As a rule of thumb, it may be best to limit a meal to 4-5 carb servings. With 17 carb servings to spread out throughout the day, we can play a bit and come up with a variety of options. If the person is not much of a snacker, then most will be in meals. We can start with 5 carb servings per meal for the three squares in a day with 2 carb servings leftover. This could be a snack or dessert of some type that is eaten at a time separated from the regular meal times. You could also opt for a more even distribution, say meals 1 and 2 with 4 carb servings, meal 3 with 5 carb servings, and a later meal 4 with 4 carb servings. Both options can work!
How Many Carbs in Real Foods and Beverages? We could get into a lot of detail here about where you find carbohydrates in foods. You can start by learning that for the purposes of diabetes, we break foods into groups. The major ones are grains and starches, milk products, and fruits. For our purposes, meats don’t really contain carbohydrates, so we don’t consider that as much at this basic level. Vegetables can get a bit tricky, though. Starchy veggies have more carbs and get pushed into the grains/starches group. These include things like potatoes, peas, and corn. Legumes, such as beans, are also pretty starchy, so for carb counting, they are pushed into the grains/starch category. Veggies that stay in the veggie group (because they have a lower amount of carbohydrates), include zucchini, carrots, cucumbers, broccoli, cauliflower, and green leafy veggies, among others. Next we will assign the serving sizes of these foods to make up a carb serving.
Carb Servings in Real Foods and Beverages Before this gets too complicated, we can generalize that about ½ cup of grains/starches, or a slice of bread, is similar to the amount provided by a small potato or a ½ cup of corn. We can “switch” or “exchange” one for the other. Those of you who have heard of, or used, the Diabetic Exchange List will note that the concept is similar. The difference is that carbohydrate counting really only considers the carbs while the exchange list separates out categories of milk/yogurt and meats according to their fat level. For instance, very lean, lean, medium, and high fat content. Again, for purposes of controlling blood glucose we will stick to the carbohydrate counting strategy. Let’s briefly go over this here because we will use it to evaluate some real meals! A grain or starch that is a 1-ounce slice of bread (1 slice from a 16-ounce loaf) or ½ cup of a cooked cereal, or 1/3 cup of rice or pasta would give you 1 carb serving of about 15 grams of carbs. For snack foods, you may want to look at the label to find out how much would give you 15 grams of carbs. Starchy veggies that give you 15 grams of carbs or 1 carb serving includes a 3-ounce potato or ½ cup of mashed potatoes, or ½ cup of corn, green peas, or cooked dried beans. Milk and yogurt are really the only dairy products on the list. Next time you go to the grocery store, take a look at the labels for other dairy products, like cheese or cottage cheese. You would have to eat 6-15 ounces of cheese (depending on the type) or almost 2 cups of cottage cheese to get the same level of carbs.
For fruits, a small fruit (like an apple) or ½ cup of unsweetened fruit like applesauce, would give you a 1 carb serving. For our purposes, about ½ cup of unsweetened fruit juice or a couple of tablespoons of dried fruit will provide 1 carb serving, but we will see later why these may not be the best choice. Those are a bit more like the items in the “sweets/other carbohydrates” categories, which include such items as cake, jams and jellies, and cookies. Non-starchy veggies do provide some carbohydrates, but only about a third as much as a similar sized serving for starchy veggies and grains. Because we know that there are about 15 grams of carbs in a carb serving, we should be able to look at food labels to figure out how many servings of carbs this particular food will provide--and add that into our total for the meal or snack for the day. Keep in mind that food labels may not have the same “serving size” listed as our table here. And, if the plan is to eat multiple servings of foods, then multiples of the carbs listed should be calculated. This should be pointed out with examples to make sure that the patient-tailored plan works. Obviously, having cups, spoons, and a scale nearby at all times would help to assure that we get it exactly right. This might limit a patient’s ability to really put this into play. So now, let’s assign some real world items to help us estimate without carrying measuring devices around with us!
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