much carbohydrate to eat, you need to consider several factors, such as whether you are male or female, small or large, and want to lose weight. As a starting point, most women need three to four carbohydrate servings (45–60 grams) and most men need about four to five carbohydrate servings (60–75 grams) at each meal. You may need less if you want to lose weight. Take a look at Table 2-2 to get a general idea of how much carbohydrate you should eat. A dietitian who specializes in diabetes care can help you determine the amount of carbohydrate that best fits your needs (see Chapter 12 for tips on finding a dietitian). When you’re using basic carb counting, it is important to keep the amount of carbohydrate you eat at meals and snacks about the same from meal to meal and day to day. This will help you better manage your blood glucose.
Are You Ready to Begin Basic Carb Counting?
We’ve covered the basics—now it’s time for you to decide if you’re ready to use basic carb counting as your meal-planning approach. Are you ready to:
1. Find a meal planning approach that fits your lifestyle and desire for more flexibility? ___ Yes ___ No
2. Find a meal planning approach that helps you achieve better control of your blood glucose levels? ___ Yes ___ No
3. Learn more about foods and how much carbohydrate is in them? ___ Yes ___ No
4. Pay more attention to what you eat and the amount you eat? ___ Yes ___ No
5. Keep food records that detail the types of foods, the amounts of food, when you eat, and how much carb is in each food, meal, or snack? ___ Yes ___ No
6. Check blood glucose levels at least two times a day and record the results? For example, select either breakfast, lunch, or dinner; then check before you eat the meal and two hours after the meal. ___ Yes ___ No
7. Weigh and measure servings? ___ Yes ___ No
8. Read the Nutrition Facts label on packaged foods to find the Total Carbohydrate content? ___ Yes ___ No
9. Spend time to learn how much carbohydrate you need to eat to keep your blood glucose levels in control? ___ Yes ___ No
10. Use a carb counting book for foods that don’t have a label? ___ Yes ___ No
Hopefully, you’re ready to move forward. There’s no doubt that carb counting requires some learning and adjustment—it can be challenging. As time goes on, carb counting will hopefully become easier for you and the process won’t seem as rigorous. So let’s get started!
Chapter 3:
Keeping Track
In This Chapter, You’ll Learn:
• How to determine your real life eating habits
• How to use a food diary and blood glucose records
• How to build a personal database of carb counting information
In a perfect world you would eat about the same amount of carbohydrate at the same times, seven days a week. However, for most people this plan just doesn’t mesh with their schedules, and with the medication options available today, people with diabetes have more flexibility in meal planning. Depending on your preferences and your daily routine, you can put together a daily meal plan that works for you.
That’s why it’s important to let your health care providers know as much about your eating style and daily schedule as you can. The best way to accomplish this is to keep records of your current food habits in a food diary. You’ll also need to figure out how much carbohydrate you eat and when on most days. Eating similar amounts of carbohydrate on a fairly regular schedule is the cornerstone of basic carb counting. Keep detailed, and honest, records. It’s the only way you can trust your results and put them to good use in managing blood glucose.
Your records are particularly important if you take blood glucose–lowering medication, and most people with diabetes do. Your diabetes care providers need to know your preferred schedule of meals and snacks and when you usually eat, because all of these factors affect the type of blood glucose–lowering medication they prescribe for you and the way they teach you to take them. Don’t let them prescribe medications for you based on an idealized nine-to-five lifestyle that simply isn’t true to your life. Some medications have different have onset and peak times and durations of action. This “action curve” needs to be in sync with when you eat. (For more information on medications and their effects, see Chapter 10.)
Seven Steps
Take a look at these seven steps to help you get a sense of your eating patterns, figure out how much carbohydrate you currently eat and the types of carbohydrate-containing foods you eat, and compare your food records with your blood glucose records. Take these steps one at a time and you’ll be well on your way with carb counting.
Step 1: Keep Food Records
Begin keeping a food diary by recording the foods you eat at breakfast, lunch, and dinner. Don’t forget to include snacks and nibbles. Yes, crumbs do count! Keep these records for a full week, including the weekend. It’s important to note both the type of food and the amount that you eat. The more accurate you can be, the more helpful your food records will be to you and to your health care provider. It helps to use a food scale and measuring cups and spoons to measure portions accurately, especially as you’re learning. You can design your own food record or use one similar to the record on Table 3-1. Your food records should include the following:
• Day of the week
• Mealtime
• Amounts of food
• Carb grams for each food
• Total carb grams for the meal or snack
Begin by just entering the food you ate for two days.
Step 2: Find the Foods You Ate that Contain Carbohydrate
After you have one week of your food diary completed, go through and circle the foods that contain carbohydrate. You can identify these foods by using the list of foods in Appendix 1 or by using one or more of the resources listed in Appendix 2. See Table 3-2 for an example. As you can see, it’s not just the rice, bread, and desserts; dairy foods and fruits contain carb, and even salad dressing may contain a few grams.
Step 3: Figure How Much Carb You Eat
Now, go back and figure out the number of grams of carbohydrate in each of the foods you ate. Table 3-3 shows an example of how this is done. Then add up the totals for each meal and snack. If you plan to use carb servings rather than grams of carbohydrate, remember that each carb serving contains about 15 grams (g) of carbohydrate.
Step 4: Sit Back and Observe
Now use the information in your food diary to see if you eat about the same amount of carbohydrate for breakfast, lunch, dinner, and snacks each day, and if you eat at the same times each day. In the two days of sample records (above), the carbohydrate in the breakfasts vary from 73 to 97 grams, and the breakfast times are very different, too. One