Carbohydrate counting

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Carbohydrate counting or "carb" counting is a meal planning tool used in diabetes management to help optimize blood sugar control. [1] It can be used with or without the use of insulin therapy. Carbohydrate counting involves determining whether a food item has carbohydrate followed by the subsequent determination of how much carbohydrate the food item has in it.

Contents

What is carbohydrate?

Carbohydrate is one of three major macronutrients found in food. The other major macronutrients are protein and fat. Carbohydrate in its simplest form is known as glucose and can contribute to a rise in blood sugar. [2] In people with diabetes, the body's ability to keep blood sugar at a normal level is impaired. Dietary management of carbohydrate consumed is one tool used to help optimize blood sugar levels. [3]

Carbohydrate content of foods

Carbohydrate is found in a number of foods including fruits, starchy vegetables (such as peas, potatoes, and corn), grains, milk and yogurt, legumes, and desserts. In general, foods such as meat, eggs, cheese, fats, and non-starchy vegetables (such as greens and broccoli) have little to no carbohydrate. [1] Other foods free of carbohydrate include small quantities of certain condiments, unsweetened coffee and tea, and sugar free sodas.

Carbohydrate content of foods is listed on the Nutrition Facts panel as "total carbohydrate". Some food labels will list specific types of carbohydrate, such as "fiber, sugar, or other carbohydrate". With carbohydrate counting, the "total carbohydrate" is used as the carbohydrate amount. [3] Carbohydrate counting can be done by either adding up grams of total carbohydrate or adding "carbohydrate units". A carbohydrate unit is simply 15 g of carbohydrate. [4]

How it is used

Carbohydrate counting can be used with or without insulin therapy.

Without insulin

When carbohydrate counting is used without insulin, it can be used as a tool to manage blood sugar levels. A certain number of carbohydrate grams or carbohydrate units is consumed with each meal and with each snack. In keeping the carbohydrate at a certain level, the blood sugar is able to remain within a normal level. The American Diabetes Association recommends starting at around 45–60 carbohydrate grams (3–4 carb units) at each meal, with potential to increase or decrease that amount. [1]

With insulin

Carbohydrate counting may be used with either a fixed insulin dosage or with a more flexible insulin dosage. Carb counting for fixed insulin dosage is done in the same manner as carbohydrate counting without insulin. The only difference is that insulin is administered with the meal. With more flexible insulin dosage, the insulin is administered in regards to the amount of carbohydrate consumed. [2] The insulin amount will vary based on the amount of carbohydrates consumed.

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A carbohydrate is a biomolecule consisting of carbon (C), hydrogen (H) and oxygen (O) atoms, usually with a hydrogen–oxygen atom ratio of 2:1 and thus with the empirical formula Cm(H2O)n, which does not mean the H has covalent bonds with O. However, not all carbohydrates conform to this precise stoichiometric definition, nor are all chemicals that do conform to this definition automatically classified as carbohydrates.

<span class="mw-page-title-main">Hypoglycemia</span> Health condition

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<span class="mw-page-title-main">Glycemic index</span> Number assigned to food

The glycemic (glycaemic) index is a number from 0 to 100 assigned to a food, with pure glucose arbitrarily given the value of 100, which represents the relative rise in the blood glucose level two hours after consuming that food. The GI of a specific food depends primarily on the quantity and type of carbohydrate it contains, but is also affected by the amount of entrapment of the carbohydrate molecules within the food, the fat and protein content of the food, the amount of organic acids in the food, and whether it is cooked and, if so, how it is cooked. GI tables, which list many types of foods and their GIs, are available. A food is considered to have a low GI if it is 55 or less; high GI if 70 or more; and mid-range GI if 56 to 69.

The Zone diet is a fad diet emphasizing low-carbohydrate consumption. It was created by Barry Sears, an American biochemist.

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Low-carbohydrate diets restrict carbohydrate consumption relative to the average diet. Foods high in carbohydrates are limited, and replaced with foods containing a higher percentage of fat and protein, as well as low carbohydrate foods.

The glycemic load (GL) of food is a number that estimates how much the food will raise a person's blood glucose level after it is eaten. One unit of glycemic load approximates the effect of eating one gram of glucose. Glycemic load accounts for how much carbohydrate is in the food and how much each gram of carbohydrate in the food raises blood glucose levels. Glycemic load is based on the glycemic index (GI), and is calculated by multiplying the weight of available carbohydrate in the food (in grams) by the food's glycemic index, and then dividing by 100.

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References

  1. 1 2 3 "Carbohydrate Counting". American Diabetes Association. Retrieved 18 July 2014.
  2. 1 2 Lopes Souto, D; Lopes Rosado, E (January 2010). "Use of carb counting in the dietary treatment of diabetes mellitus". Nutricion Hospitalaria. 25 (1): 18–25. PMID   20204251.
  3. 1 2 Evert, A. B.; Boucher, J. L.; Cypress, M.; Dunbar, S. A.; Franz, M. J.; Mayer-Davis, E. J.; Neumiller, J. J.; Nwankwo, R.; Verdi, C. L.; Urbanski, P.; Yancy, W. S.; American Diabetes Association (1 November 2013). "Nutrition Therapy Recommendations for the Management of Adults With Diabetes". Diabetes Care. 36 (11): 3821–3842. doi:10.2337/dc13-2042. PMC   3816916 . PMID   24107659.
  4. Mahan, L. Kathleen; Escott-Stump, Sylvia (2008). Krause's Food & Nutrition Therapy. Saunders Elsevier. pp. 776–777. ISBN   978-1-4160-3401-8.