When people think about managing their diabetes, many think about watching their sugar intake, but just as important are carbohydrates.
“The terms sugar, starch, and carbohydrate are often used interchangeably because they're all broken down into simple sugars in the body,” says Jackie Matsunaga, MMN, RDN, LMNT, LD, CDES, a Nebraska Medicine-certified diabetes care and education specialist and nutritional therapist.
Carbohydrates often get a negative reputation, but Matsunaga says that consuming a minimum amount of carbohydrates in your daily diet is essential for energy and brain function. Carbohydrates are broken down into glucose, the brain's main source of energy.
If you have diabetes, your body can't process carbohydrates as efficiently as a non-diabetic person. “Determining how many carbohydrates you should eat per day is not a perfect science because different people process carbohydrates differently,” Matsunaga says. “So how much you can eat and what types of carbohydrates work best in your diet will vary greatly depending on your constitution and any medications you may be taking.”
The key to managing carbohydrates is consuming them in moderation, being aware of the types of carbohydrates you're eating, and combining them with protein and healthy fats, Matsunaga says.
When thinking about sugar and carbs, Matsunaga says it's good to know which ones are better for you than others.
The types of carbohydrates and sugars are:
- Monosaccharides Carbohydrates are the building blocks of foods that are processed more quickly by the body. This includes added sugars, which we'll discuss later, but are also found in fruit (fructose) and dairy products (lactose). Although these sugars should be avoided, they shouldn't be eliminated from the diet, as some provide many essential vitamins and minerals. For example, milk and other dairy products provide calcium, vitamin D, and protein. Fruit provides fiber and other vitamins and minerals that have many benefits for the body.
- Added sugars Sugar is sugar that is added to foods like candy and processed foods. Foods with large amounts of added sugar can cause blood sugar spikes and offer no nutritional benefit.
- Refined carbohydrates Found in foods like white bread, white rice, and white pasta, these are carbohydrates that have been stripped of fiber and beneficial nutrients. They are processed more quickly by the body and can cause blood sugar spikes.
- Complex carbohydrates Whole grains contain fiber and other important nutrients, and because fiber takes longer for your body to process it, they don't spike your blood sugar as much as refined carbohydrates do.
“To keep things simple, I tell my patients to look at the total carbohydrate count when reading the label, because that includes dietary fiber, sugar, and added sugars,” Matsunaga says.
To determine if you're making healthy food choices, Matsunaga also recommends looking at the fiber content and amount of added sugars in your food. The more fiber and the less added sugar, the better your food choice is.
Of course, fruits and vegetables don't have labels to check how many carbs they contain, so you have to be aware that just as some fruits are higher in sugar, some vegetables are more starchy than others, and if you do eat these foods, you should eat less of them, Matsunaga points out.
Starchy vegetables include corn, peas, potatoes, sweet potatoes, and winter squash like acorn squash and butternut squash, while vegetables like kidney beans, broccoli, cauliflower, and Brussels sprouts are often referred to as “free” because they're very low in carbohydrates and high in fiber, Matsunaga says.
Fruits like bananas, grapes, and mangoes are usually higher in sugar than other fruits and you can eat less of them, while berries are generally lower in sugar and higher in fiber so you can eat more of them.
“Vegetables and fruits are highly nutritious, so it's a good idea to eat whatever you like. However, you should be careful about the amount of starchy vegetables and fruits you eat,” Matsunaga says.
Examples of carbohydrate intake include:
- Small Apple
- 1 kiwi
- Half a banana
- 1 cup berries
- Medium Peach
- 1 slice of bread
- 1 cup nonfat yogurt
- 1 small ear of corn
- Half a medium sized potato
When it comes to meals, Matsunaga recommends using the plate method to determine appropriate portion sizes. First, identify which parts of your meal are carbohydrates. The goal is to have a quarter to a third of your plate be carbohydrates. Divide the rest of your plate between protein and non-starchy vegetables. “Portion control and balancing your plate are key to keeping carbs in check,” Matsunaga says.
Also, try to keep your eating patterns consistent. For example, don't reserve all your carbs for the day in one big serving of pasta for dinner. “It's hard on your body to process and metabolize them all at once,” Matsunaga says. “It's better to eat carbohydrates in small portions throughout the day.”
When it comes to snacking, Matsunaga recommends combining carbs with protein and healthy fats, which will help you keep your carb intake moderate, get a sustained dose of protein, and keep your blood sugar levels more under control.
Snack options with healthy carb and protein combinations include:
- Whole Wheat Crackers with Cheese
- Apple with peanut butter
- Popcorn with nuts
- Greek yogurt and granola
- Boiled eggs and a small piece of toast
Carbohydrate management is key for people with diabetes to maintain a good diet, but remember that carbs are good for you when consumed in moderation, says Matsunaga. Carbohydrates are even better when combined with fiber and protein to give you more sustained energy throughout the day.
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