This section is necessary for everyone to read at least once. When you understand the complexities of carb counting you need to ask yourself if you need to learn it or not.
If you are an insulin user who wants to eat higher carb meals even just sometimes you do have to learn and become highly proficient at this skill.
If you are not on insulin you may prefer to have a “done it for you” sort of diet such as Dr Annika’s, the Life without bread diet or coming later in the How To: Follow Dr. Bernstein's Dietary Plan section.
If you are an insulin user who would prefer not to carb count you will still need to have some idea of what sorts of relative amounts of carb different foods have. Whether you choose Dr Annika’s, LWB or Dr Bernstein’s diet you are still going to have to cut your carbs gradually and be very consistent particularly in the run in phase when insulin doses are reducing. You need to give this carb counting a very good effort. When you are eventually stable on a low carb eating plan that suits you it is entirely possible to keep to doing what you know works and hardly carb count after that point.
There are several methods of carbohydrate counting that are commonly used.
2. Exchange method.
3. Carb factors.
4. Nutritional labels.
5. Nutritional scales.
These all have their pros and cons. You need equipment or information sources for some of them. No matter how accurate you try to be you are likely to end up with an approximation of the carb content. The more of these methods you become comfortable with the more versatility you will have under different circumstances. In all cases you need to make the best estimate you can and notice the results you get. What would you change next time if your post meal blood sugars are not within your particular target range? By giving it your best guess and then testing you can build up a profile of how your body, medication doses, and insulin can cope with that particular meal at that particular time of day.
HOW TO LOOK UP CARB LISTS.
Carb lists of food items can come from various sources. There are published books, web based resources and chain restaurants will often publish leaflets to give you an idea of the carb count or have the information on a web site.
One of the difficulties however is knowing what portion size they have actually measured. Sometimes a food is listed by the amount of carb in 100g which is a little over 3 ounces. Other times cups, tablespoons, handfuls or the number of items eg grapes are listed with carb count. The most accurate way is when you have a standardised and individually packaged portion.
The website resources section in the metabolic syndrome section has some carb counting sites to help you get started. In addition here is list from some fast food and other restaurants. To put these figures into context the Atkins diet ranges from 20-120g of carb a day.
Cajun Chicken deli wrap 48g
Large fries 53g
Sachet ketchup 4g
Chocolate ice cream sundae 26g
Big Mac 44g
French fries regular 28g
BBQ dip 12g
Apple pie 27g
Regular vanilla milkshake 63g
Kentuky Fried Chicken
Original recipe chicken drumstick (one) 7g
Chicken fillet burger 36g
Crispy strip (one) 6g
One medium slice Italian pizza 27-38g
Portion of lasagne 63g
One slice of garlic bread 11g
One portion of boiled basmati rice 110g
Chicken tandoori 2g
Chicken korma 16g
Vegetable curry 15g
Beef curry 6g
Naan bread 80g
Baked potato 70g
Chicken pie for one 32g
Meat pie for one 33g
Shepherds pie for one 37g
Battered fish 21g
Sweet and sour pork 34g
Chips/Fries small 31g
Chips/Fries medium 50g
Chips/Fries Large 73g
HOW TO USE THE EXCHANGE METHOD OF CARB COUNTING
The exchange method of carb counting was used for many years. Diabetics and their carers were taught what quantity of a carbohydrate containing food amounted to 10g, 12g or 15g of carbohydrate. The Life Without Bread Diet which I have described in the Metabolic section uses a certain number of 12g carb portions a day.
In general this method can be more accurate than the list method. For instance a third of a cup of cooked rice is around 15g versus about 110g for your average Indian restaurant rice portion. It is still subject to some error of course.
The American Diabetes Association have come up with a rough quantity guide to help you. This is for a woman’s hand.
one clenched fistful = one cup
palms sized quantity = 3 oz
thumb tip = one teaspoon
handful = 1 or 2 oz of snackfood
whole thumb size = 1 oz
With all the inbuilt imprecision that this method of counting has you will always have to compare what you think you ate versus the results you got. When you do have such items as nutritional scales or relatively accurate portioned control amounts it is helpful to compare what they look like versus your usual portion size to improve your eyeballing accuracy.
American cup sizes are used throughout.
All of these portion sizes amount to about 15g of carbohydrate unless stated otherwise.
1/2 cup beans
one small slice bread
1/2 cup cereal
one cup milk = 10g
1/2 cup cooked pasta
1/3 cup cooked rice
one large apple
5 small apricots
6 apricot halves in juice drained
one small banana
half a large banana
20 blackberries or blueberries
3 medium clementines or satsumas
3/4 cup fruit salad
one medium grapefruit
ten large grapes or 20 small grapes
2.5 kiwi fruit
3/4 of a medium mango
2 slices of melon
one large nectarine
one large orange
2 medium peaches
7 slices of canned peaches in juice drained
one medium pear
3 pear halves in juice drained
3 slices of pineapple
3 medium plums
4 dried prunes
1.5 tablespoons of raisins
1/2 cup raspberries
one tablespoon sultanas
One medium slice of bread 24g
one slice of french bread 1.5 cm in length
1.5 bridge rolls
1/2 medium sized roll
one slice currant or raisin bread
1/4 cup breadcrumbs
1/2 medium chapati
one toasted crumpet
1/2 currant bun
1/2 English muffin
2 small slices garlic bread
one medium hamburger bun 24g
one large hamburger bun 42g
1/2 hot cross bun
1/5 naan bread
1/2 sweet pancake 15cm diameter
2 large poppadoms
one pitta bread
one small scone
2 taco shells
1/2 corn or flour tortilla
For most breads a 30g serving has 15g of carb
2 tablespoons canned sweetcorn
one small corn on the cob
120g roast parsnips
1/2 cup frozen peas
1/2 small baked potato
one very small boiled potato
2 tablespoons mashed potato
For most vegetables
1/2 cooked = one cup raw = 5g carb
1 and a half cooked = 3 cups raw = 15g carb
1/2 cup of cornflakes, fruit and fibre or rice krispies
2 tablespoons muesli
1 cup puffed cereal
1/2 cup rolled oats made with water
one biscuit of weetabix
For most cereals a 20g serving has 15g of carb
Apple juice 150mls
drinking chocolate powder 20g
unsweetened grapefruit juce 180mls
unsweetened orange juice 170mls
unsweetened pineapple juice 150mls
soft drink 140mls
1/2 cooked barley
1/3 cup bulgar wheat
1 and a half teaspoons cornflour
1/3 cup couscous
2 and a half tablespoons wholewheat flour
2 tablespoons white flour
1/2 cup pasta
1/3 cup cooked rice
1 and a half tablespoons dried rice
1/2 cup tinned spaghetti
3 tablespoons baked beans
1/2 cup kidney beans
2 heaped tablespoons lentils or split peas
3/4 cup custard
3/4 cup evaporated milk
1 and a half cups milk
1/2 cup vanilla ice cream
2 heaped teaspoons sweetened yoghurt
1/2 standard bounty bar
25g bar of chocolate
1/3 standard mars bar
1.5 small milky way
1/2 snickers bar
3 fingers of kit kat
one finger of twix
3 cream crackers
3 cups cooked popcorn
25g packet of crisps
one penguin biscuit
two ginger nuts
one 9g shortbread biscuit
one 5cm square cake without icing
one 2.5 cm square cake with icing
one mr kipling french fancy 19g
one choc chip cookie 8g
one small slice chocolate cake
2/3 large croissant
one danish pastry
1/2 jam donut
1/2 slice fruit cake
one jaffa cake 9g
3 level teaspoons jam
one small slice madeira cake
1/2 an individual jam tart
1/2 mince pie
3 level teaspoons sugar
one small slice swiss roll
one small waffle
For most dry biscuits and cakes a 25-30g serving will have 15g of carb
For most sweets a 10-20g serving will have 15g of carb.
HOW TO COUNT CARBS USING CARB FACTORS
The carb factor is the percentage of carbohydrate present in a food. If an apple has a carb factor of 0.13 this means that 13% of the weight of that apple is carbohydrate. If your apple weighs exactly 100g this would contain 13g of carb.
To use this method you need a list of carb factors and a set of scales to measure out the weight of your food portion. Nutritional scales have the carb and other factors built into them but you can use any scale provided it is sensitive enough. Digital scales may therefore be preferable to analogue scales.
John Walsh and Ruth Roberts book, “Pumping Insulin” has a list of about 300 foods at the back.
The site Friends with Diabetes is a site for diabetics who wish to follow a kosher diet. There is lots of helpful information of help to everyone else too.
Also, this site www.medexplorer.com/nutrition/nutrition.dbm gives you carb content and other nutritional information too.
HOW TO COUNT CARBS FROM NUTRITIONAL LABELS
When you pick up many items of processed food you will find nutritional labels on them. How do you know how much carb is in the portion you intend to eat?
For the purposes of illustration lets say I decide to have a meal of a half can of lobster bisque soup, 3/4 of a can of spaghetti bolognese and half a can of mandarin oranges in light syrup with a dollop of tinned heavy cream.
I look at the lobster bisque. It lists :
Energy 51 kcal
(of which sugars 1.2g
(of which saturates 1.2g)
I want to eat half a can and fortunately the figures for this are listed too.
How to I know how much carb to count? In this case it is easy because it is on the tin. Carbohydrate 9.8g per half tin (of which sugars 3.5g).
The important thing to remember is that it is the carb count and not just the sugar count that matters.
Now for the main course. Tinned spaghetti bolognese. The tin weighs 400g.
I pick up this can and go straight to the carb count.
It says carbohydrate 13.2 per 100g with sugars being 2.4g of this.
Per half can serving there is 26.3g with sugars being 4.8g of this.
Ignoring the sugar content as usual I see that if I want 3/4 of the can I will need to do a little sum.
Although this is an easy sum to do I would like to go though what your old school teacher called “the working” so that it is easier to do this cross multiplication technique with more awkward amounts.
If 100g weight = 13.2 carbs what does 300g weight contain?
Write it like this 100g = 13.2
300g = X
Now cross multiply like this:
100g x X = 13.2 x 300g
From algebra you may remember that if you want to know what X is you need to move the 100g to the other side of the equal sign. When you do this it has to go below the 13.2 x 300g sum to indicate that this is now going to be divided.
So you get:
X = 13.2 x 300g
Using a calculator the answer is:
This cross multiplication technique can be used not only for counting how much carb is in a certain weight of food if you have the carb factor or carb count from a list but how much of a certain food you can have to stay within a certain carbohyrate limit.
Now dessert. Mandarin orange segments in light syrup. The can weighs 312g and the drained weight of the can is 170g.
Per 100g for the fruit and the syrup the carb count is 14g of which sugars is 14g.
For half a can the carb weight is 22g of which sugars is 22g. The fibre content is 1g.
This fibre content is pretty low so can be ignored in this calculation. For certain foods with a significant fibre level you may be best to deduct it from the total carb count. Fibre affects the bulkiness of the meal but as it passes throught the gut without being absorbed you don’t need insulin to cover it. Because bulk can affect blood sugars through the effect of glucagon released from gut distention Dr Bernstein suggests a compromise by deducting half of the fibre from any given meal.
In this case we can find out how much carb is in half a can just by looking at the label. But what if this information was not supplied? What if the can contents had been shared out and you really had no idea what proportion of the can you had been given?
Lets go back to the carb factor information. 14g of the weight of the 100g of this food is carbohydrate. If you weigh your portion on an accurate scale and it comes to 156g how much carb is this.
100g = 14g carb
156g = X carb
100 x X = 14 x 156
X = 14 x 156
X = 21.84g carb
Now lets add the cream. Per 100g the carb count is 3.6g. For a 50g serving size the carb count is 1.8g. The can contains 283g so a serving size is 283/50 = 5.66th of the tin. A good couple of tablespoons by the look of this for a very low carb count.
Now add up your meal carb content:
Lobster bisque 9.8
Spaghetti bolognese 39.6
Mandarin oranges 22
Total = 73g
Now, you won’t be surprised to hear after what we’ve been telling you about high amounts of carbohydrate messing up your blood sugar control, weight and metabolism that this menu is for carb counting lessons only. You want to eat much healthier meals that this canned rubbish don’t you?
HOW TO COUNT CARBS USING NUTRITIONAL SCALES
Nutritional scales come in two main types. The cheaper type has a booklet with food lists and you enter the code of what you are weighing into the machine. More expensive models have an inbuilt computer with the foods listed and you click on the food you are weighing. These tend to have a larger database and can be used without having to have a booklet.
The nutritional scales give you the calorie, salt, protein, fat, cholesterol, fibre and carbohydrate counts for any given weight of food. There are memory features too.
The Salter nutritional scale that I have has 800 foods listed from the USDA database. It cost me £32 from Amazon. If you go onto the USDA site to find an even larger range of foods and have an accurate enough scale you do not really need to have nutritional scales. I have found it a convenient and useful method and our family even have guessing games about how many carbs a particular food portion contains. I have even taken it into restaurants to carb count food!
HOW TO EYEBALL PORTIONS OF CARB CONTAINING FOOD
Out of all the carb counting methods I have discussed this is the method subject to the most error and yet it is the most commonly used.
To get success with this you have to practice and practice with the other more accurate methods of weighing out small portions of food and using packaging information, charts or nutritional scales to come to what still is an approximation of the amount.
It has been shown that eyeballing is reasonably effective up to about 30g of carb portions but once the portions get bigger the estimates get considerably less accurate. For this reason you are better to look at your food and even move it about in your plate a bit try to replicate the portions you use at home with a known carb count and then add them up.
It always amazes me just how much carb potatoes have compared to for instance cauliflower, broccoli and green beans. Some eye ballings rules are that a golf ball size of mashed potato is 10g of carb and a woman’s fist size of cooked low starch vegetable is 5g.
The lower the carb count of your meal the easier it is in general to figure out the carbs. There is less room for error with what you think is one golf ball size of mash compared to say six such estimated portions which is not unusual in some restaurant meals. This goes of course for rice, bread, pasta, chips, cakes and sugary sauces too.
Partly for these reasons of difficulty in carb estimation and also because of the variability in the absorption and effect of insulin injections it is far less troublesome to simply keep these food items to a minimum for insulin users.
Type 2s who don’t use insulin also find that their sugars spike with anything other than modest portions of these items because they don’t have a supply of immediately releasable stored insulin in their pancreases.
Carb counting is not an exact thing. Different breads are sliced to different widths for instance. Cup sizes vary too. In the carb comparison questions one option will have at least twice or half of the relative amounts of the other three options.
1. 12g of carbohydrate is present in all of these except…
a one thin slice of bread.
b one cup of broccoli.
c one cup of rice.
d half a grapefruit.
2. 15g is present in all of these except…
a Half a cup of beans.
b Half a cup of cereal.
c Half a medium roll.
d One hamburger bun.
3. 15g of carb is present in all of these except…
a One large banana.
b One medium pear.
c Three pear halves in juice.
d 3 medium satsumas.
4. 15g of carb is present in all of these except..
a Half of a small baked potato.
b A packet of crisps.
c A small portion of Burger King chips.
d Two tablespoons of mashed potato.
5. 15g of carb is present in all of these except…
a Three fingers of kit kat.
b Half a standard bounty bar.
c One standard snickers bar.
d One finger of twix.
6. 30g of carb is present in all of these except…
a A slice of pizza (the size of the ones with a thin base served at the buffet in Pizza hut)
b A donut.
c Two oatcakes.
d An individual jam tart.
Have you got it?
1. C. A cup of rice is about 30g. More than twice the carb count of the others.
2. D. A small hamburger bun is around 24g and a large one 48g. The others are about half the carb count.
3. A. A large banana is about 30g.
4. C. A small portion of Burger King chips is about 32g. Even then the consistency between these small portions varies a lot. I know. I’ve sat counting chips to find out.
5. C. A standard snickers bar is 34g.
6. C. Two oatcakes at 7g each are around 15g.
Jo Sutton an Australian Dietician compiled the carb lists that I have used here.
Where to Next?
We are all now going to move onto the How To: Do the Atkins Diet diet section. What? Did I hear this right? Surely everyone in the developed world knows how to do Atkins? They all think they do! That’s for sure. For a different take on the most famous diet in history I’ll see you there.