rel="nofollow" href="#i000028000000.jpg" alt="remember"/> The benefits are cumulative. Controlling portions helps with weight loss; losing weight improves insulin action; better-working insulin improves blood-glucose control; and controlling diabetes and weight lowers your risk of heart disease! For more tips on eating smart for your weight and heart, see Chapter 16.
The glycemic index (GI) is a tool to measure how individual foods are expected to impact blood-glucose levels. The basic concept may be used in addition to carb counting and other carb management strategies. It’s true that not all carb foods affect blood glucose in the same manner, which is why pizza isn’t used to treat hypoglycemia. Liquids move through the stomach quickly, so the sugars in juice and soda show up in the bloodstream in a matter of minutes. That’s just what you need if you’re trying to treat hypoglycemia. Juice isn’t what you need if blood-glucose levels are already running high.
Instead of deferring to a chart to choose from low, medium, or high GI foods, it pays to get to the bottom of why foods behave the way they do (check out Chapter 10). With a solid grasp of the concepts, you can make food choices work in your favor. For example, whole grains and legumes have fiber and a lower glycemic index than white refined grains and breads. Meals that contain fiber and balanced amounts of carbohydrate, protein, and fat produce a blunter blood-glucose rise and more stability in blood-glucose levels.
The human body relies on glucose to fuel many functions. The biggest user of this essential fuel is the brain. The minimum recommended intake for carbohydrate is 130 grams of carb per day, whether you are 1, 10, or 100 years old. Who says and why? The National Institutes of Health establish nutrient intake guidelines. The guidelines on carbohydrate intake assure adequacy for vital functions and baseline needs. Actual intake should be assessed individually, as discussed in the following sections.
Figuring out how much carb you need
Glucose is an important fuel for the human body. You can’t live without it. The brain requires a steady supply of glucose around the clock and lifelong. Glucose is the preferred fuel source for muscles and other tissues. Foods supply glucose and other nutrients.
Timing your carb intake
There’s something to be said about proper meal spacing. If meals are too close together, blood-glucose levels can climb. If meals are too far apart, appetite can overtake willpower and make portion control difficult. Going to bed on a full stomach can lead to elevated glucose levels overnight and into the next day. Try having dinner at least three hours before going to bed. Eat three main meals four to six hours apart. Tuck in a snack if needed to curb appetite or to supply energy for exercise. Determine how to divvy up the carbs among meals and snacks to regulate appetite and blood-glucose levels in Chapter 6.
Matching insulin timing to digestion timing takes a bit more finesse. It’s critical to understand onset, peak, and duration profiles for the insulins you use. Chapter 6 reviews insulin action times. Chapter 10 looks at the variables that affect digestion timing. Some foods digest quickly (liquids, simple sugars, and refined grains), while others digest more slowly (whole grains, foods with fiber, and meals higher in protein and fat).
Make use of the many carb-counting resources available to you. The following sections introduce food labels, food lists, menus, brochures, apps, websites, and more.
Looking at the label lingo
Nutrition details are clearly marked on packaged foods. Look for the Nutrition Facts food label. First, identify the serving size. The calories, total carbohydrate, fiber, and everything else on the label refers to “one serving,” not necessarily the whole package. Did you know that fiber isn’t digestible so you can subtract it from the total carbohydrates to get a more accurate carb count?
Tune in to Chapter 7 to sharpen your supermarket savvy and find out all about food labels. You can even take a sneak peek at the new look; the food label is undergoing a makeover.
Gathering carb-counting resources
Some of the most nutritious foods are harvested, not manufactured. Don’t let the lack of a label keep you from reaching for wholesome foods. You can still closely estimate carbohydrate counts in fruits, vegetables, legumes, and grains with food composition lists (see Chapter 8 and Appendix A). The Exchange List concept groups foods by macronutrient composition; the items on a list have similar amounts of carbohydrate, protein, and fat. Every item on the fruit list, for example, identifies a portion size that equals 15 grams of carbohydrate: A small apple or orange, 17 grapes, 1 cup of cantaloupe or raspberries, or ½ banana all provide the same amount of carbohydrate. Variety isn’t only the spice of life; it’s also a great way to assure you get a wide array of important nutrients.
Measuring cups are essential for accuracy. Cooking from scratch? No problem! Chapter 8 also walks you through figuring out how to calculate carbs in your homemade recipes. Add tools to your carb-counting tool chest by tapping into online resources (flip to Chapter 9).
Increasing carb-counting accuracy
With type 1 diabetes, insulin doses must be carefully matched to carbohydrate intakes. Once you’ve mastered carb counting 101 (food labels and carb-counting lists), you’re ready for more advanced carb-counting strategies.
A food scale can verify exact carb counts on numerous foods, including fruits. By weighing foods occasionally, you’ll hone your ability to accurately estimate carbs in the future. Chapter 8 provides a list identifying the number of grams of carb per ounce of fruit. Weighing nails the carb counts in baked potatoes or a chunk of French bread.
Apps and web-based food databases offer nutrition facts on ethnic foods and combination foods, including pizza and lasagna. Chapter 9 describes how to combine the technologies: your food scale and a food database or app. Weigh your food item – a tamale, for example – and then plug the weight of your tamale into the food database to get an exact carb count on the item you’re about to eat. There is no need to do this for every food every time, but it sure helps to improve your ability to guestimate more accurately in the future.
Eating for health and happiness and reaping the rewards of fitness should be a lifelong commitment through all ages and stages of life. The following sections cover these and the other pillars of diabetes management.
Eating
