I met Hope Warshaw a couple of years ago at the annual ADA conference, when I interviewed her on eating with diabetes. She's smart, down-to-earth, and witty. Just the kind of expert you wish you could take home with you!
A Guest Post by Hope Warshaw, registered dietitian, CDE, and famous food author
As you put carbohydrate counting into everyday practice do you go from one wild ass guess to the next? That's understandable! At best carb counts are educated guestimates (my non-Webster approved word) for myriad reasons: the methods used to analyze/provide carb counts on nutrition labels, mysterious math allowed by FDA on nutrition labels, limited point-of-purchase nutrition facts for produce, and hidden carbs in restaurant foods; to name a few.
Accurate carb counting is not, as some diabetes care providers suggest, a set of simple skills. It's a constant challenge within the context of juggling real life and diabetes. Check out these practical pointers to increase your number of educated guesses.
Build Your Top 100: Use the premise that we're creatures of habit when it comes to foods to your advantage. Think about it. Do you assemble meals and snacks from the same 100 foods day after day? Rather than constantly searching for the carb counts of the same foods and adding up your counts, spend a couple of hours once building your top 100 list, then revise on occasion. Here are the steps:
1. Brainstorm and record a list of the foods you regularly eat. Look in your refrigerator, pantry, and freezer.
2. Record the amounts of these foods you eat. (Do this over a few weeks — as you eat them. Weigh and measure the foods to maximum accurate carb counts.)
3. Determine the carb counts from resources (below).
4. Total the carb counts for common meals and snacks.
5. Make this information portable and carry it with you.
Create your history: Continuing with the creatures of habit premise, record a few notes about your blood glucose responses to these meals. Think about how you could improve post-meal BGs — less/more food, more insulin, take insulin earlier, or extend part of the dose.
Train eyes and hands by weighing and measuring foods (on occasion): Weighing and measuring foods constantly is a pain and most people don't do it. That's understandable. But consider doing it on occasion to familiarize yourself with and keep you honest about portions and carb counts. Well trained eyes and hands assist you at home and when you eat out. As a mental reminder and for quick access, keep measuring equipment on the counter.
Purchase a high-tech food scale: A food scale ($40 — $100) that provides the gram weight of foods and/or the carb counts of a database of foods can be helpful. A source is The Diabetes Mall.
Learn carb counts of restaurant foods: Again put the creature of habit premise into action. You likely eat similar foods from a short cadre of cafeterias, fast food joints and restaurants and order from a similar handful of menu options. Focus your time and efforts to gather the carb counts for these foods through:
- National chain restaurants: Walk up and order restaurants often provide complete nutrition information on their websites whereas the sit-down and order chains do not. Little to no information is available for independents.
- Worksite cafeteria, local breakfast or sandwich shops: Ask to see the nutrition facts labels (if available) for foods you regularly eat. Example: bread, bagels, muffins, coleslaw, three-bean salad, etc.
- Carb counts of ethnic foods: Check out the nutrition facts of similar foods in the supermarket — refried beans, salsas, tortillas, Chinese sauces, or frozen stir fry dinners. Peruse cookbooks. Pay particular attention to the hidden carbs—sugar in marinades, corn starch as thickeners.
Resources for Carb Counts:
- www.ars.usda.gov/nutrientdata (USDA's National Nutrient Database)
- The Diabetes Carbohydrate and Fat Gram Guide, by LeaAnn Holzmeister, RD, CDE. American Diabetes Association
- The Doctor's Pocket Calorie, Fat and Carbohydrates Counter, by Allan Borushek. Family Health Publisher. (Updated annually and available here)
- Guide to Healthy Restaurant Eating, 3rd ed. American Diabetes Association. (Nutrition information for the top 60 U.S. chain restaurants)
- Eat Out, Eat Right, 3rd ed. (guidance and some specific nutrition information about American and ethnic fare)
- Nutrition in the Fast Lane—The Fast Food Dining Guide. Franklin Publishing Inc. Indianapolis, IN, 800-634-1993 or here. (Updated annually)
Invest a few hours upfront to gather accurate carb counts for the foods and meals you eat regularly. Turn your wild-ass-guesses into educated guestimates to improve your carb counting accuracy and, in turn, blood glucose control.
Hope is not only a dietitian and diabetes educator, but also a freelance writer and the author of several best-selling diabetes and nutrition books published by the American Diabetes Association and other publishers. Learn more about Hope and her publications at www.hopewarshaw.com.