Carbohydrates supply energy
Carbohydrates, also called carbs, are the sugars and starches in breads and grains, potatoes and other vegetables, and in fruits and beans, and those foods are the major contributors of carbs as a source of energy needed by the body’s cells. After eating carbohydrate foods, the digestion process breaks them down and the glucose content is passed through the walls of the intestines into the bloodstream and there circulates to reach the cells that require glucose.

How can we determine which foods can be considered as low carb foods?
Not all carbohydrates are the same in their immediate impact and speed of entry into the bloodstream, and it is the rate at which they are reduced to the sugar in the form of glucose that helps define whether they are considered as low carb foods or otherwise. Carbs can also be classified as refined or unrefined, with white breads, pastas and white flours being especially considered as refined carbs while foods such as whole grained breads, fruits, beans and most vegetables are classified as unrefined.

To indicate the relative rate of entry of carbs into the bloodstream, a scale has been devised called the Glycemic Index, also referred to as the GI for short. The GI ranks individual carbohydrate food items with an index number that compares them to glucose that has the assigned value of 100. The other food sources are ranked in the relation of their speed of conversion to glucose and for convenience are categorized as follows:

• high carb foods have GI values higher than 70
• medium carb foods have a GI value of 56 to 70
• low carb foods have GI values of 55 and lower

As can be seen, the low carb foods provide sugar at a slower rate of entry into the blood stream and this allows the body to more easily maintain a balanced amount of sugars in the blood. The high carb foods on the other hand, tend to cause spikes, blood sugars elevated to higher levels, not a preferred condition and certainly potentially harmful for people with diabetes or prediabetes.

A great deal more can be said on the topic of carbohydrates. We should distinguish between low carb foods and low carb diets. Low carbohydrate diets restrict the proportion of any types of carbohydrates in relation to the proportions of proteins and fats, whereas low carbohydrate foods can best be described as those that have lower Glycemic Index values.

Many well-known diet approaches using low quantities of carbohydrates have been described in such best selling books such as The Atkins Diet and The South Beach Diet. Taking opposite views to those popular books, there are many advocates of a medium dietary intake, represented by about 50 percent carbs, 25 percent proteins, 25% fats with no more than 10 percent of fat being saturated fats.

On my companion website, Diabetes Menu Guide, you might wish to read a related article on low carbs, to do so, just click on this link Low Carbohydrate Approach in Meal Planning. And check out these link for more on the Glycemic Index and Glycemic Load.

The amount of carbohydrate in a meal or in a food item will not usually comprise the entire calorie amount of any food. To adjust the measurements for this, the Glycemic Index has been modified to produce a companion set of numerical values called the Glycemic Load. The Glycemic Load takes into account that particular amount of carbohydrate in an entire food item, giving a set of values.

High glycemic index carb foods include:

White and non-whole wheat breads, pastas, many breakfast cereals, potatoes, baked goods.

Low glycemic index carb foods include:

Fruits, many vegetables, whole wheat breads, legumes (beans and peas)

When consumed in reasonable amounts, some low glycemic load carb foods are:

Breads - whole grain pumpernickel bread, Soy and flaxseed bread, other whole grain breads.
Breakfast cereals – cooked oatmeal, All-bran, Bran Buds.
Fruits ans berries – grapefruit, strawberries, cherries, watermelon, apples, pears, peaches, plums, grapes, oranges, blueberries, raspberries, and others
Vegetables – cabbage, spinach, lettuce, kale, chard, broccoli, cauliflower, and most others.
Dairy and soy foods – soy milk, low fat milk, low fat yogurt
Nuts and seeds – flax seed, peanuts, cashews, walnuts, almonds, pecans, brazil nuts, hazel nuts – Nuts should be raw or dry-roasted.

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. . . as devised by my health care team

Factors to consider in determining a diabetic food list

The dietitians at the Diabetes Education Center of my local hospital devised a meal plan for me that is based on and built around the amount of carbohydrates they believe should be in my daily diabetic food list. And that, together with the necessary background, is what I would like to share with you, knowing that we are all different but the methods and factors leading to establishing the diet should be similar for most individuals. But first, some general information about foods and nutrient categories.

Carbohydrates, Proteins, and Fats

The nutrients in the foods we eat, and need to eat to keep us alive, are proteins, carbohydrates and fats. We also need water, vitamins, minerals, and fiber. But it is the major nutrient categories that we are concerned with here and the ratios of those nutrients that go to make up our daily food list.

Carbohydrates are the major source of energy needed by all the cells of the body to function and perform their myriad and constant chemical activities. Sources of carbohydrates are breads, pastas, grains, puddings, sweets and deserts – and those are not always the best sources to include in the diabetic food list. For breads choose the whole grain versions. Other carbohydrate sources include vegetables, fruits, beans, nuts, and low-fat dairy products

Proteins are needed for growth and maintenance of muscles, organs, and body tissues among other things and the main sources of proteins in our foods are from beef, fish, poultry, eggs, dairy products, seeds, and nuts.

Fats, also a source of energy, are needed to assist in the functioning of the body. Dietary fat provides essential fatty acids that our bodies do not manufacture. Fats are an important component of a healthy diet.

Although we are all different in body shape and size, most of us maintain our weight within a narrow range of a few pounds through eating similar amounts and types of meals each day. The foods we consume provide the energy needed to sustain life and the amounts of energy provided by the various foods are measured in units called calories.

About food and calories

Any of the calories of energy obtained from our food intake that is not immediately needed by the cells of our body is stored for later use in the body’s fat cells. It is the continued accumulation of that excess energy obtained from the foods we eat that results in us becoming fatter. So to avoid gaining weight, don’t eat more calories than you need each day, but that leads to another topic for discussion elsewhere.

Different categories of food provide different amounts of calories. Food amounts can be measured in grams or ounces, in North America the gram weights are more usual. For each one gram of weight, carbohydrates and proteins provide 4 calories and fats provide 9 calories.

To maintain current weight

The body needs a supply of energy all the time, whether we are active or not. The total number of calories required by an individual each day in order to supply their energy needs, and maintain their current weight, depends on several factors and can easily be calculated. Those are, mainly, current weight, height, gender, and level of physical activity, where the more active and strenuous work and life-style demands will require more calories for their support.

As a general guideline, the American Heart Association answers the question; “How many calories should you eat each day?” by offering a chart showing gender, age, activity levels (sedentary, moderate, active) but does not take into account height and weight. From this chart it can be seen that a moderately active female between 30 and 50 years of age requires 2000 calories per day compared with a male of the same age and activity level who would require 2400 to 2600 calories per day. Those amounts will be too high for people of generally smaller stature.

But there are Calorie Calculators available on the internet that can be a little more precise. I favor the one at Freedieting.com that requires the following input and provides an estimate of calories needed to support them. You will note the appropriate activity level must be enetered.

Maintenance:    XXXX Calories/day

Fat Loss:         XXXX Calories/day

Extreme Fat Loss:     XXXX Calories/day

Using the above calculator, I have determined that my own calorie intake should be about 2000 calories per day, a lot lower than the 2400 to 2600 given by the American Heart Association chart but I am older, perhaps less active too.

Looking further, I see that for a moderate diet it is suggested that the daily food list it should be comprised of 45% carbohydrates – 900 calories, 30% protein – 600 calories, and 25% fat – 500 calories.

That is a lower percentage of carbohydrates than is suggested by the American Diabetes Association, and a higher percentage than is suggested by the doctors who advocate the Low Carbohydrate approach to treating diabetes.

Caution:
Please keep in mind, that the above charts and tables are meant for the healthy non-diabetic person and we diabetics should consider them only for comparison while we continue to seek advise from the medical professionals who are treating us for diabetes.

But now, let us see the percentages of carbohydrates in the diabetic food plan devised for me by my local Diabetes Education Center. To do this go to: My Own Diabetic Food Plan Part 2.

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My Diabetic Food Plan is based on the inclusion of specified amounts of carbohydrates in each meal and snack throughout the day, as listed below.

There are no specified amounts for the other nutrients, the proteins and fats, that, although essential to maintain the body in good health, play only a minor role as a source of glucose –  except in the absence of carbohydrates.

The diabetic food plan has been devised for me by the dietitons at the Diabetes Education Center of my local hospital. It is simple and easy to follow and is printed conveniently on one side of a sheet of paper. It merely lists the suggested number of grams of carbohydrate for three main meals eaten about four hours apart and interspersed with a snack about two hours after each meal. And I have added an extra snack at or before bedtime.

The rest of the Food Plan page is taken up with lists of half a dozen foods in 15 gram quantities under the headings Vegetables, Fruits, Dairy, Breads etc., and Snacks. The 15 gram quantities make it easy to calculate how many portions of any category need be selected to make up the required meal amount for carbohydrates, providing a sort of mini diabetic food list.

The details, the amounts of carbohydrates recommended
Breakfast, at 8 0’clock, is 60 grams, Lunch about mid-day is 45 grams, and Supper (called dinner by some) at about 6 pm is also 45 grams. The snacks are each 15 grams, that’s a total of 60+15+45+15+45+15+15 = 210 grams. Those are carbohydrate grams @ 4 calories per gram which equals 840 calories of carbohydrate each day. That is a little less than the amount suggested by the Calorie Calculator referred to in Part 1 of this article, which was 900 calories, but close enough.

There is no limit to the amounts of protein or fat on this dietary plan but common sense tells me that if I eat too much I will gain weight and that is something I don’t wish to do.  The Calorie Calculator suggested that my total calorie intake should be about 2000 calories, with 840 taken up by the carbohydrates, it means 1160 calories for the proteins and fats allowance for the day.

Referring to the Calorie Calculator again, it suggests 25% fats in a 2000 calorie daily food intake, that’s 500 calories @ 9grams of fat per calorie = 56 grams of fat approximately, leaving about 660 grams of protein to provide the 2000 calories.

My plan provide 210 grams of carbohydrates daily
To summarize the rather lengthy description above, my diabetic food plan provides 2000 daily calories from 840 g, carbohydrates, 660 g, of protein, and 56 g. of fat. s

COUNTING CARBOHYDRATES IN A DIABETIC FOOD PLAN

Carbohydrates are the main nutrient source of glucose and will have the biggest effect on  blood sugars. The foods supplying the protein and fat, while providing a minor amount of glucose, will not affect blood sugar levels. Those foods include meat, fish, poultry, eggs, cheese, margarine, and oils — but they can, of course, increase weight and cholesterol if eaten in too large a quantity.

For the carbohydrate portion of a meal, I can choose from the following food list, each item  contains 15 grams of carbohydrate. For more choices, I can add 15 gram amounts of whatever carbohydrate foods I wish to the lists.

Food Lists – with essential supplementary information

This site provides a link to the Food Lists on our companion blog-site, Diabetic Menu Guide, where  the various categories of food items such as Vegetables, Meats, Fats, Fruits, Fish, Cereals, Dairy, Breads, Jams and spreads, and Drinks are shown together with nutrition details.
To access that information, click:  The Food Lists,

The importance of carbohydrates
Foods are comprised mainly of carbohydrates, proteins, fats, and fiber, and of course, water. One of the most important factors of our diabetic foods is the amount of carbohydrates in our meals. Carbohydrates are a primary source of the glucose that enters our bloodstream and every newly diagnose diabetic should become familiar with the effects of the carbohydrate portion of their meals.

The speed at which carbohydrates are broken down by the body into glucose varies with the individual food item, in some foods it is fast in others not so fast, and the slower it is the better it is for the diabetic.

The Glycemic Index
A widely accepted tool in diabetic food planning is the Glycemic Index, GI for short. The GI is a numerical ranking of how fast individual food items are reduced to glucose and enter the bloodstream compared to a reference standard such as sugar or white bread. The GI is another reference source for diabetics to learn about. In a companion post on this site we provide an explanation of the Glycemic Index and the Glycemic Load.

The Practical Value of the Food Lists Provided on this Site

Since there are few foods that are “off-limits” to the diabetic, it is the accompanying information regarding the nutritional content of the individual servings of the specific food items that is important.

From these values, the total nutritional content can be determined for selected food items that comprise a meal and it can then be seen whether they meet the objectives of the menu plan regarding calories, and the preferred ratios of carbohydrates to proteins to fats.

Although most food items are acceptable to the diabetic, some may require modest proportions and certainly some items are less desirable compared to others, for instance, whole wheat breads are a better choice that white breads.

The diabetic food list includes many food entries and a lot of supplementary information. Why it is necessary to know the nutrient and calorie content of foods is explained below.

If You Are Newly Diagnosed as Diabetic:
The following might be of interest: click on for details
About Diabetes, from my own experience
About Diabetes, a simple explanation

More is needed than just a list of foods
To feed yourself properly, you will need to include the right combination of Proteins, Carbohydrates, and Fats, the primary nutrients needed by the body to sustain life, the building blocks, so to speak, to maintain good health.

So as well as the basic food lists, we include the amounts of Proteins, Carbohydrates, and Fats in those foods, and will be adding the Glycemic Index values and the Glycemic Load values shortly.

And more is needed than just a list of foods and their nutrient content
Why? Because you need to know how much of those foods to include in your diabetic menu to provide the energy needed to carry out your daily activities in the workplace and to support your personal life style activities. Food energy is measured in Calories  so the calorie content of the individual foods is also listed in our lists of diabetic foods.

Calorie content based on individual needs and a target weight
As well as calorie content, even more information is needed to plan and prepare foods for your daily meals. The total daily calories required for individuals varies and should be known at the beginning when first establishing a diabetic meal plan and that can be based on the weight you wish to maintain, or the weight you may wish to gain or lose.

Do not follow a quick weight loss diet plan if you wish to lose weight,  we suggest that weight reduction can best take place in small increments over an extended time in that way the weight lost  is likely to stay “off” – whereas it has been shown that weight loss through quick weight-loss diets almost always is regained. Visit our post on the role of weight-loss in diabetes.

Now in Preparation:
More details on specific food items such as Seeds, Nuts, Fats and Oils, Grains, Vegetarian and Vegan dietary approaches, Regional dietary habits: Mediterranean, Okinawan, etc. High and Low carbohydrate approaches to diabetic menu planning. Etc etc.

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The objective of a dietary plan or diabetic food list for the diabetic person is primarily to aid in the control the amounts of glucose in the bloodstream and to keep the glucose levels within as narrow a range as possible so that they do not exceed acceptable levels by too great an amount.

There will be spikes in blood glucose levels after eating a meal or snack that will vary based on the type of food eaten and its carbohydrate content and the speed in which the resulting glucose is produced when digestion of the food takes place. That is why it is good to know, when compiling a diabetes food list, which foods are the source of the highest carbohydrate content and are the speediest broken down to glucose,  so that they can be eliminated or at least limited in quantity. Those can be identified by reference to the Glycemic Index and Glycemic Load index avail able elsewhere on this site.

To maintain glucose levels as evenly as possible throughout the day it is often suggested that meals should be of about the same size and interspersed with snacks, rather than any one meal being much larger than the others.

The essential nutrients needed by the body for its energy and maintenance are obtained from the carbohydrates, proteins, and fats in the foods consumed each day. Those foods are broken down to their nutritional chemical components in the digestion process and released through the walls of the intestine to be carried in the bloodstream to the many organs of the body where they are then selectively taken up as required into the body’s millions of cells.

When present, the carbohydrate fraction of the foods is the main source of glucose in the bloodstream and so it is the carbohydrate content of foods that is the major factor around which diabetic food plans are constructed. The more carbohydrates there are, the more glucose will end up in the blood stream. After a meal or snack, when glucose is produced, the impaired body mechanisms of the diabetic person in the production of insulin, needed to conduct the glucose into the cells that require it, and the desensitized sensors on the outer membranes of those cells, results in the unhealthy levels of the glucose remaining in the blood.

From that statement the question could be asked:
“Then why not reduce the amounts of carbohydrate to a minimum so that less glucose is produced to overload the bloodstream?”

That is a good question that would seem to require an answer in the affirmative. But the diabetic associations of most countries do not seem to concur.

The High Carbohydrate approach
The ADA (American Diabetes Association) and others recommend what can be considered a high carbohydrate diet of 50 to 60 percent Carbohydrates, 15 to 20 percent proteins, and 25 to 30 percent fats based on total calories consumed. A calorie is the unit applied to the measurement of energy provided by components of food.

The Low Carbohydrate approach
Although in the minority, many physicians advocate an “Anti-ADA” approach that, conversely, recommends a low carbohydrate content in meals to minimize the amount of glucose that can enter the bloodstream.

A number of books have been published by doctors providing details on diets that have successfully brought their patients to a reversal or near reversal of their diabetic condition or at least a very good control of their glucose levels. The carbohydrate content of those diets is low, from about 20 to 35 percent. There are many different versions, you’ve probably heard of the Dr.Atkins and South Beach Diets, but there are others, some less extreme than those.

The American Academy of Family Physicians defines low carbohydrate diets as:
“Low-carbohydrate diets restrict caloric intake by reducing the consumption of carbohydrates to 20 to 60 g per day (typically less than 20 percent of the daily caloric intake). The consumption of protein and fat is increased to compensate for part of the calories that formerly came from carbohydrates.”

It should also be noted that the American Diabetes Association, after carrying out their own clinical studies with patients on a low carbohydrate diet, agreed that the low carbohydrate was successful in achieving lower blood glucose levels. However, their stated opinion was that such a diet was not likely to be adhered to for a sufficiently long period of time and they therefore keep to their current recommendations regarding carbohydrates. For additional information on lower carbohydrate foods, see our companion site: Diabetic Menu Guide and the reference to low carbohydrate effectiveness can be found in our post :  Low Carbohydrate Approach.

There are other health concerns voiced by members of the medical and health care profession in which reservations are expressed regarding the adoption of a low calorie diet.

Caution:
All matters of diet, exercise, weight-loss, and especially any changes being contemplated, should be discussed with your doctor who will provide guidance on your treatment and should refer you to other health care professionals for more complete answers if necessary.

One other factor regarding carbohydrates is that they exist in several different forms that are usually classified as either “simple” or “complex”. The difference being in their chemical structure that results in a speedier breakdown to glucose for the simple form and a longer time for the complex forms. This makes the complex forms generally more favorable to include in a diabetic menu plan and a special index, known as the Glycemic Index, has been devised to rate the varying speeds of conversion of carbohydrates to glucose.

Vegetarian, Vegan, and Others
There are other dietary approaches that are effective in the management and control of blood glucose and that do not so much emphasize the carbohydrate content of foods. Among these are the Vegetarian and Vegan life styles that have many virtues from a viewpoint of nutrition. They concentrate on vegetables and fruits that are automatically low on the Glycemic Index, the speed in which their carbohydrate content is converted to glucose.

However, in North America, only a small percentage of the population follow a vegetarian or vegan regime, we are a meat-eating and fat-rich food consuming nation.

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