Making Good Food Choices II: Becoming Carb-Aware

Why should you care about carbohydrates? Of the major types of nutrients — carbohydrate, protein, and fat — carbohydrates have the greatest impact on blood sugar levels.

This Healthy Eating article will help you become carb-aware and carb-wise:

• It describes what carbohydrates are, where they come from, and why eating foods that contain carbohydrates is a good thing.
• It explains why low-carb diets may not be the best weight loss advice for people trying to control their diabetes.
• It offers tips on how to get the benefits of different kinds of fibers by increasing fiber-rich foods in your diet: fruits and vegetables, whole-grain products, high fiber cereals, legumes, and nuts.

Carb Curiosity

Do you pine for potato skins? Have an appetite for an apple? Both of these treats contain carbohydrates. In fact, carbohydrates are in many of the foods you eat — milk, fruits, vegetables, grain products, table sugar, and baked goods. So it's important to understand how they fit into your Diabetes Control for Life™ Program.

Carbohydrates and Calories. The carbohydrates you eat break down during digestion to glucose (sugar), the body's favorite source of energy. After the body has broken down carbohydrates into glucose, the glucose goes to the body's cells. The cells then use the glucose for energy — if there's enough insulin around. Each gram of carbohydrate provides four calories.

So far, so good; however, any extra carbohydrates the cells don't use for energy are turned into fat and stored.

Many people with diabetes think they need to avoid carbohydrates in their diet, especially “sugars” such as table sugar and honey. Not true. For weight loss, it's important to limit calorie intake, with roughly half of those calories coming from carbohydrates. Foods containing carbohydrates provide other nutritional benefits that are important to health. So eat that apple!

Making Wise Carb Choices. A slice of whole-grain bread and eight gummy bears both contain about the same amount of carbohydrates, but the nutritional value between the two is worlds apart. Research studies now show that both the amount and type of carbohydrates impacts blood sugar levels. As you might guess, the gummy bears raise blood sugar levels more than the whole-grain bread. The bread also provides many more vitamins and minerals than the gummy bears and is a good source of fiber. So whether you count exchanges or carbohydrates, choose your carbohydrates wisely because some are better than others for people with diabetes.

The Lowdown on Low-Carb Diets. We can all breathe a sigh of relief that the low-carb craze has lost its flare and many people are no longer following such diets. Most of these plans made money by preaching that carbohydrates are “bad,” and that to lose weight, a person has to eat as few of them as possible.

This is probably not the best advice for someone with diabetes — unless the person's doctor supervises closely. Here's why:

• The initial weight loss on a low-carb diet is usually impressive, but it's mostly water. If this substantial water loss causes dehydration in a person with diabetes, it can cause serious problems.
• Dehydration can be serious for people taking medication for high blood pressure because it can cause a rapid drop in blood pressure that leaves the person feeling weak and dizzy.
• Blood sugar levels can drop dramatically because of the lack of carbohydrates in the diet, and they may go dangerously low if the dieter is taking medication to help control blood sugar levels.
• Once medications have been adjusted, the dieter has to stay with the low-carb program. And no cheating! Shifting back to a high-carbohydrate diet causes another set of problems and another readjustment of medications.

Carbohydrates are included in structured diabetes management programs for a variety of reasons:

• They help keep blood sugar levels stable, when not overeaten.
• They taste good!
• They're satisfying.
• They fuel the brain.
• Foods with carbohydrates contain other important nutrients for good health, such as fiber, vitamins, and minerals.

Fabulous Fiber: Good for You and Your Blood Sugar

Delicious, ripe fruits and berries. Crisp, crunchy, colorful vegetables. Flavorful grains. Savory nuts. A mouth-watering bowl of popcorn. These are among the many tempting foods that offer you abundant fiber, that all-important component of a healthy diet.

Grandma may have called it roughage, but she knew it was good for you. Nutrition experts also have known for a long time that fiber contributes to good health. And some studies have suggested that fiber can help people lose weight, which can help control their glucose levels. But for years, the experts didn’t offer official guidelines on how much fiber a person should get every day to get these benefits. Now some countries are setting guidelines for fiber. The U.S. Food and Nutrition Board has issued some recommendations for daily adequate intake (AI) of fiber.

Are You Getting Enough? For example, the recommended AI for adults in the U.S. older than 50 years of age is 30 grams for men and 21 grams for women. For adults younger than 50 years of age, the recommended AI is 38 grams for men and 25 grams for women. By these guidelines, fewer than 5 percent of adults in the United States eat enough fiber. In one recent government study, the average daily intake of fiber was about 15 grams — well below recommended levels!

Why Fiber? Fiber is important for many reasons, starting with the fact that it may help food and waste move through the digestive system. And fiber in a meal or snack helps people feel fuller longer. Some kinds of fiber can help carry excess cholesterol out of the body so it’s not absorbed in the blood. Other kinds help slow the rate at which blood sugar rises after a meal. This action helps people with diabetes keep blood sugar at moderate levels.

New Definitions of Fibers. The U.S. Food and Nutrition Board defines total fiber as the combination of dietary fiber and functional fiber. Here’s how these types of fibers compare.

Dietary fibers are found naturally in plant foods such as lentils and veggies. They’re the part of carbohydrates that aren’t digested when foods containing carbohydrates are eaten. Dietary fibers carry food through the digestive system and help people feel full.

Functional fibers are also nondigestible carbohydrates that act like dietary fiber, but they can come from synthetic as well as natural sources. And they’re usually added to food. An example of a synthetic fiber that can be added to food products is fructooligosaccharides (FOS), which is in Glucerna SR™. An example of a natural source of functional fiber is pectin, which is extracted from citrus peel. You may have noticed that it’s often used in jams and jellies.

Increase Your Fiber Fitness. Luckily, it’s easy to increase your fiber intake. The chart below lists fiber-rich foods. Increase your fiber intake gradually over several weeks so your body has time to adapt to the change.

Keep in mind that while you’re increasing your fiber intake, you’ll need to drink lots of fluids.

The following table gives you the breakdown of how many calories each macronutrient provides.

Figuring In Fiber

1. Here is a list of good sources of fiber. For each item, think about whether it’s a regular part of your diet (that is, you eat it at least once a week). Decide which of those items you don’t eat regularly you would be willing to try. Look for ways to work them into your diet.

   Fiber Source	Consumed at Least Once a Week?		If No, Willing To Try?
   Apple with peel	___Yes	___No	___Yes	___No
   Banana	___Yes	___No	___Yes	___No
   Broccoli	___Yes	___No	___Yes	___No
   Carrots	___Yes	___No	___Yes	___No
   High-fiber cereal	___Yes	___No	___Yes	___No
   Oatmeal (not instant)	___Yes	___No	___Yes	___No
   Whole-grain bread	___Yes	___No	___Yes	___No
   Brown rice	___Yes	___No	___Yes	___No
   Baked potato with skin	___Yes	___No	___Yes	___No
   Lentils, split peas, etc.	___Yes	___No	___Yes	___No

2. Now set a goal to try one of those fiber-rich foods this week. Which one have you decided to try?

Summary

• Carbohydrates are an important part of your nutrition. They provide energy and other nutrients like important vitamins and minerals. And you need fiber for digestive health and bowel regularity.
• Some carbohydrate choices are better than others. Eating slowly digested carbohydrates such as those in Glucerna SR can help you control your blood sugar better.
• You can get the benefits of different kinds of fiber by including different kinds of fiber-rich foods in your diet — for instance, fruits and vegetables, whole-grain products, and high-fiber cereals.