Sunday, July 22, 2012

Carb Counting

Thanks to Cousin Lisa, I have yet another awesome topic to write about that I wouldn't have otherwise thought to cover if she hadn't asked a great question:  how do I know how many carbs are in everything I eat?  Yeah, a completely integral part of being a diabetic, but something I haven't necessarily thought conscientiously about in ages...  great question!

Breaking things down to the absolute basics for those unfamiliar with nutritional components: the food we eat is primarily divided into three categories - protein, fat and carbs.  Protein comes from things like meats, seafood and eggs. Fats come from things like nuts, ice cream and non-lean meats.  Carbohydrates are in foods that contain fruits, vegetables, grains and sugars.   It is important to note here that these categories are not mutually exclusive and that they often blend together in each of the meals we eat every day...  taking a cheeseburger as an example you've got protein, fat and carbs in several combinations like so:

So when "carb counting" you are looking to identify how many grams of foods from this third category are in whatever food you eat and, based on the hamburger example above, you can see that carbs come from more than just bread.  As a diabetic, I have to sit down at every meal and put a number to the plate of food in front of me... does it have rice? does it have potatoes? what hidden carbs are there? what kind of bread is used? is there milk in it? is the protein breaded? what is in the sauce?  And don't forget about drinks! I've found that most drinks have more carbohydrates than one might imagine...  1 cup of milk has 13 grams of carbs; a cup of coffee only has carbs if you add sugar and milk, but you have to account for the effect caffeine may take on BG; soda - don't even get me started; and juice, talk about straight sugar in a glass!

When I first was diagnosed and had to meet with a dietary nutritionalist to learn how to carb count, I was completely overwhelmed by the prospect of knowing what was in everything.  Fortunately I was previously acquainted with reading nutrition labels and that made things much, much easier - all I had to do was grab a measuring cup and do some basic math.  But when I don't have access to nutrition labels (like at restaurants, when other people cook for me or when making things from scratch) it got much more difficult.

I remember a conversation I had with a long time family friend back in Colorado who is also T1 about how he knows what carbs are in what.  Having been diabetic since he was just a kid his response was simply that "at some point, you just know."  Now a year and a half in, I get what he means and I "sight read" my food, but it has taken much practice and research to get to this point.

So what resources did/do I use?

Not being a terribly big fan of technology (face it, I'm anti-facebook and twitter), my absolute favorite go to nutrition guide of choice is the Prevention Magazine Nutrition Adviser book (ISBN-10: 0875962254).  It breaks down most foods (not complete meals, but specific components of meals) into a standard nutrition label - so for foods that might not have a label (ie apples and bananas) it is a great way to learn the necessary stats.    I'd definitely recommend this book!

If you're an internet searching type, the website of choice that I use most often is (I believe it is also in the form of an iPhone app).  It is a gigantic online database that you can sift through for basic ingredients or for comprehensive meal choices at specific restaurants.   It mainly covers chain restaurant, fast food or ready-made grocery store meals, so it does leave a gap of information for local Mom-Pop type places, but it can give you an estimate of what the stats are of a certain dish to guess off of.  So for example, the lasagna bolognese at the Macaroni Grill has 720 calories, 41.3 grams of fat, 46 grams of carbs and 41 grams of protein.  Assuming that the lasagna you make at home contains similar ingredients and is a comparable portion size, it like has 40-50 grams of carbs as well.

Another phone app resource that some of my diabetic friends use is called "Track3". From what I understand it is a comprehensive diabetes app that provides nutrition information and an exercise/meal/BG journal.  I don't personally use this so I cannot speak to it from experience, but from what others have said it is a great resource for carb content searches and data collection.  It seems to be geared toward diabetics, but I'm sure there is a way to make it work for non-diabetics as well if interested.

At the end of the day, carb counting is about being as close as possible to the right number of carbs (within 5-10 grams is usually okay), but mistakes are inevitable.  You can miscount and under bolus sending sugars sky rocketing or you can over count/under eat and send sugars into hypoglycemic ranges. Obviously it is ideal to know what you're getting exactly and to avoid such miscalculations, so understanding how to read nutrition labels and researching restaurant nutrition information is a great first line of defense.  But once you know some basics by memory - like most rice and pasta is about 40 grams per cup, an apple is 20 grams give or take a few and bread is typically between 15-20 grams a slice - it gets easier to eyeball meals you can't measure exactly and roll on with life.

I will admit that I still struggle with foods I am unfamiliar with and I do find myself in situations that are outside of my carb counting comfort zone.  Like when going to ethnic restaurants that use ingredients that I can't pronounce, let alone identify or when someone else cooks something I've never eaten before, I'm often left to take a wild guess or to ask the awkward question of "um, what is this?"  So heads up, when serving dinner to me or any other diabetic, you might be asked to show the recipe card  for the dish or the cans/boxes your ingredients came from just so a better, more accurate guesstimate can be made. Ultimately it's the responsibility of the diabetic to read what is in front of them, but don't be surprised or offended if they ask for more information or opt out of a certain dish for health reasons.

Well I hope that this post begins to answer your question to at least some degree, Lisa!  There are other ways to watch what you eat as a diabetic - such as no-carb/low carb diets or using the glycemic index - but I'll skip that for now since they're a bit more complicated than carb counting.  If any reader would like more info on those options/what they mean, I'd be happy to go into more detail about them in a future post - just let me know.

Until then, I have two challenges for all of you:

1) Check out the nutrition labels on your food and to track how many carbs you eat during the day.  Measure your food, conscientiously note when you snack and what is in your drinks.  It's a very different perspective of your plate than you might be used to, so please feel free to share your experience in a comment :)

2) Take a look at the following pictures and descriptions of common breakfast meals.  Whoever can give me the total number of carbs (including decimals... silly engineers) in a post comment first will get a prize! (And it is a sweeeeeeeeeeet prize!)

1) Thomas' brand Cinnamon raisin bagel with 3 oz regular cream cheese.  2) A Starbucks blueberry scone and grande iced coffee with milk and two sugar packets.  3) Two scrambled eggs, two medium slices of bacon, two pieces of white-bread toast and 1 cup of home-made hash browns.  4)  1 cup multi-grain Cheerios with one medium banana and 1 cup 2% milk.  5)  Seven 4" homemade buttermilk pancakes with 1/2 cup real maple syrup and 1 Tbsp of butter.  6) 12 oz fresh orange juice. 
As soon as someone guesses correctly, I'll post the answer for all to see :)

Good luck!


  1. 515.8 grams (now that I inlcuded the pancakes)

    It'd be a PITA to look this up for every meal! I remember a year ago when you were "fresh" at this; we'd spend the first 5 minutes of every meal out of the house using our two phones to look up each component of the proposed meal.

    And when I show up at home with coffee or a smoothie, I always make sure to have looked up the carb count at the restaurant when I order it (most chains have a nutritional info card but you have to ask for it).

    Great Blog - keep it up!