Diabetes and Carbohydrates: What should I know?

Diabetes, which is a disease characerized by raised blood sugar levels (blood glucose), affects 25-26 million people in the U.S. Diet and exercise are very important components of controlling the effects of diabetes. This post discusses carbohydrates specifically, how they affect your blood sugar levels, and why it's a good idea to limit processed/refined starches and sugars in our diets (whether we have diabetes or not). If this post relates to you and you'd like more guidance on your specific diet, ask your physician or dietician.



(COURTESY OF http://www.diabetes.org/)

Nowadays, we hear about carbohydrate all the time.
Foods that contain carbohydrate raise blood glucose. By keeping track of how many carbohydrates you eat and setting a limit for your maximum amount to eat, you can help to keep your blood glucose levels in your target range. You may also be interested in our book, Diabetes Carbohydrate and Fat Gram Guide, 3rd Edition.

Did you know there are three main types of carbohydrate? There are

• Starches (also known as complex carbohydrates)
• Sugars
• Fiber

You'll also hear terms like naturally occurring sugar, added sugar, low-calorie sweeteners, sugar alcohols, reduced-calorie sweeteners, processed grains, enriched grains, complex carbohydrate, sweets, refined grains, and whole grains.
No wonder knowing what kind and how much carbohydrate to eat can be confusing!

On the nutrition label, the term "total carbohydrate" includes all three types of carbohydrates. This is the number you should pay attention to if you are carbohydrate counting.

Starch

Foods high in starch include:

• Starchy vegetables like peas, corn, lima beans, and potatoes
• Dried beans, lentils, and peas such as pinto beans, kidney beans, black eyed peas, and split peas
• Grains like oats, barley, and rice. (The majority of grain products in the US are made from wheat flour. These include pasta, bread, and crackers but the variety is expanding to include other grains as well.)

The grain group can be broken down even further into whole grain or refined grain.
A grain, let's take wheat for example, contains three parts:

• bran
• germ
• endosperm

The bran is the outer hard shell of the grain. It is the part of the grain that provides the most fiber and most of the B vitamins and minerals.
The germ is the next layer and is packed with nutrients including essential fatty acids and vitamin E.
The endosperm is the soft part in the center of the grain. It contains the starch. Whole grain means that the entire grain kernel is in the food.
If you eat a whole grain food, it contains the bran, germ, and endosperm so you get all of the nutrients that whole grains have to offer. If you eat a refined grain food, it contains only the endosperm or the starchy part so you miss out on a lot of vitamins and minerals. Because whole grains contain the entire grain, they are much more nutritious than refined grains.

Sugar

Sugar is another type of carbohydrate. You may also hear sugar referred to as simple or fast-acting carbohydrate. There are two main types of sugar:

• naturally occurring sugars such as those in milk or fruit
• added sugars such as those added during processing such as fruit canned in heavy syrup or sugar added to make a cookie

On the nutrition facts label, the number of sugar grams includes both added and natural sugars.
There are many different names for sugar. Examples of common names are table sugar, brown sugar, molasses, honey, beet sugar, cane sugar, confectioner's sugar, powdered sugar, raw sugar, turbinado, maple syrup, high-fructose corn syrup, agave nectar, and sugar cane syrup.
You may also see table sugar listed by its chemical name, sucrose. Fruit sugar is also known as fructose and the sugar in milk is called lactose. You can recognize other sugars on labels because their chemical names also end in "-ose." For example glucose (also called dextrose), fructose (also called levulose), lactose, and maltose.
If you are looking for information about artificial sweeteners, try this section.

Fiber

Fiber comes from plant foods so there is no fiber in animal products such as milk, eggs, meat, poultry, and fish.
Fiber is the indigestible part of plant foods, including fruits, vegetables, whole grains, nuts, and legumes. When you consume dietary fiber, most of it passes through the intestines and is not digested.
For good health, adults need to try to eat 25 to 30 grams of fiber each day. Most Americans do not consume nearly enough fiber in their diet, so while it is wise to aim for this goal, any increase in fiber in your diet can be beneficial. Most of us only get about ½ what is recommended.
Fiber contributes to digestive health, helps to keep you regular and helps to make you feel full and satisfied after eating. Additional health benefits, of a diet high in fiber — such as a reduction in cholesterol levels — have been suggested by some so may be an additional benefit.
Good sources of dietary fiber include:

• Beans and legumes. Think black beans, kidney beans, pintos, chick peas (garbanzos), white beans, and lentils.
• Fruits and vegetables, especially those with edible skin (for example, apples, corn and beans) and those with edible seeds (for example, berries).
• Whole grains such as:
• Whole wheat pasta
• Whole grain cereals (Look for those with three grams of dietary fiber or more per serving, including those made from whole wheat, wheat bran, and oats.)
• Whole grain breads (To be a good source of fiber, one slice of bread should have at least three grams of fiber. Another good indication: look for breads where the first ingredient is a whole grain. For example, whole whe+at or oats.) Many grain products now have "double fiber" with extra fiber added.
• Nuts — try different kinds. Peanuts, walnuts and almonds are a good source of fiber and healthy fat, but watch portion sizes, because they also contain a lot of calories in a small amount.

In general, an excellent source of fiber contains five grams or more per serving, while a good source of fiber contains 2.5 - 4.9 grams per serving.
It is best to get your fiber from food rather than taking a supplement. In addition to the fiber, these foods have a wealth of nutrition, containing many important vitamins and minerals. In fact, they may contain nutrients that haven't even been discovered yet!
It is also important that you increase your fiber intake gradually, to prevent stomach irritation, and that you increase your intake of water and other liquids, to prevent constipation.
Because fiber is not digested like other carbohydrates, for carbohydrate counting purposes, if a serving of a food contains more than or equal to 5 grams of dietary fiber, you can subtract half the grams of dietary fiber from the total carbohydrate serving of that food.