Understanding Carbs

Georgetown Center for Adult Medicine - January 27, 2020

Find your balance.

You’ve heard it all. From carb-free to low-carb, to whole and empty carbs, it’s hard to know what it all means.

Get smart on carbs.

The main purpose of carbs in the diet is to provide energy as your body’s main fuel source. The carbs plus the amount of insulin you have in your body determine your blood sugar levels and have a big impact on how you feel.

Whether you’re trying to lose weight or simply balance your blood sugar, carbs play a big role. Refined carbs are things like white bread and sugar-sweetened drinks that tend to cause spikes in blood sugar. You’ve probably heard these called empty carbs, or even ‘empty calories.’

Know the three types

There are three main types of carbohydrates in food: Starches, sugars, and fiber. Starches—or complex carbohydrates—include starchy vegetables, dried beans, and grains. Sugars include those naturally occurring (like in fruit) and added (like in a cookie). And fiber comes from plant foods vs. animal products like eggs, meat, or fish.

Counting carbs

Carbohydrate counting, or "carb counting," helps many people with diabetes manage their food intake and blood sugar, and it’s most often used by people who take insulin twice or more times a day.

Carb counting may give you more choices and flexibility when planning meals. It involves counting the number of carb grams in a meal and matching that to your dose of insulin. With the right balance of physical activity and insulin, carb counting can help you manage your blood sugar. It sounds complex, but with help from a registered dietitian nutritionist (RDN) or certified diabetes educator (CDE), you can learn how to find the right balance.

How much carbohydrate?

The best place to start is to figure out how many carbs you are eating at your meals and snacks now. Tracking your food intake and your blood sugar before and about 2 hours after your meals for a few days can provide useful information for you and your diabetes care team to see how different meals impact your blood glucose and determine the right amount of carbs.

What foods have carbohydrate?

Foods that contain carbohydrate or “carbs” are:

grains like rice, oatmeal, and barley
grain-based foods like bread, cereal, pasta, and crackers
starchy vegetables like potatoes, peas and corn
fruit and juice
milk and yogurt
dried beans like pinto beans and soy products like veggie burgers
sweets and snack foods like sodas, juice drinks, cake, cookies, candy, and chips
Non-starchy vegetables like lettuce, cucumbers, broccoli, and cauliflower have very little carbohydrate and very little if any impact on your blood sugar.

Reading food labels will tell you how much carb is in foods that tend to be processed. Foods without labels such as fruits and vegetables are often better options and you can learn to estimate how much carbohydrate is in it.

Protein and fat

With carb counting, protein and fat in meals are also a factor but have less impact on your blood sugar than carbohydrates. Foods high in protein often contain fat, and both protein and fat can affect your blood sugar. While there is currently no clear method of counting grams with protein and fat to predict impact on your blood sugar, if you notice unexpected outcomes in your blood sugar when you eat foods high in protein and/or fat, talk with your diabetes care team about the best way to plan for those meals.

Using food labels

Carb counting is easier when the information is on the food label. You can look at how much carbohydrate is in the serving of food you plan to eat. The two items on the label that are most useful are the serving size and the total carbohydrate amount.

Look at the serving size. All the information on the label is about this amount of food. If you will be eating 2 or 3 servings, then you will need to double or triple the information on the label.
Look at the grams of total carbohydrate.
Added sugars and other bullets below the total carbohydrate listing are included in the total carbohydrate. They are called out to provide more information about what you are eating.
Finding the right balance of carbs, calories and portions that will satisfy you can take time and may also change as other factors in your life change.