IN THIS CHAPTER
Using measuring cups and scales
Watching carbs at meals
Handling snacks and desserts
Controlling blood-glucose levels requires having a handle on carb intake. It helps to problem-solve situations in advance and go into the day with a plan for how to best manage meals and snacks. The tips in this chapter may help you strategize.
Saving a Step with a Measuring Cup
Measuring cups can be used to dish up a serving from the stovetop to your plate. The stackable versions come in various portion sizes. Scoop up the desired amount of food with the appropriate cup, level off the top, and put it on your plate. Precision at home also trains your eye so you can be a better guesser when it isn’t possible to measure, such as in a restaurant.
If you frequently have rice at home, buy a rice bowl that holds an appropriate amount, such as a cup. If you fill it to the correct level (not mounded), you automatically know you are having a cup each time you eat from that bowl. Use a measuring cup to find out how much your cereal bowls, cups, and glasses hold. Then whenever you use those dishes, your portion will be a known quantity. If you have a hard time controlling how much fruit you consume in one sitting, purchase a bowl that holds one cup and use it to regulate fruit servings. Use a small, festive-looking dish that holds a half cup for pudding or ice cream. Let’s face it — the tendency is to fill up any dish. A smaller dish that looks full is psychologically more satisfying than a big dish that looks half empty.
Check out Chapter 8 for more tips on using weights and measures to count carbs.
Weighing Fruits in Advance
The Exchange Lists (see Appendix A ) say a small apple or a medium peach each count as one fruit exchange equaling 15 grams of carb. Estimating is okay, especially if you have type 2 diabetes; just keep in mind that a small fruit is the size of a tennis ball and a medium fruit is the size of a baseball.
If you have type 1 diabetes, it pays to weigh. At least weigh enough examples to hone your eyeballing skills. If you weigh a few bananas, you’ll be able to estimate more accurately in the future. I’m going to walk you through an example, and I agree it seems tedious, but it isn’t as tough as it sounds. You’ll need a food scale (some models cost under $10). Multiple apps and websites provide nutrient details for foods by weight. I use Calorie King for this example, as it is easily accessible online ( www.calorieking.com ) or via their app (see Chapter 9 for more about Calorie King).
Once you access Calorie King, use the search box to look up “apple.” Then click on “Apples, with Skin, raw.” The default size displayed says “extra small [4 oz. with refuse, 2.5” dia] (3.6 oz).” Scroll to change the measurement; choose “oz (1 oz).” Next, weigh your apple on your food scale. Say it weighs 6.5 ounces. You type the actual weight into the serving size box on the app. Calorie King does the math for a 6.5-ounce apple and displays the result in the familiar Nutrition Facts food label format. In this example, the Total Carbohydrate is 25.4 grams and the fiber is 4.4 grams. You can subtract the fiber because it doesn’t digest. The revised count is 21 grams of carb.
Once you are set up with a food scale, weigh all the fruits in your fruit bowl. Use a permanent marker to write the number of grams of carb directly onto the banana peel or orange peel, or onto a sticker if the fruit has an edible skin. Later in the week when you grab a piece of fruit, the carb count is already done. Periodic use of a food scale hones your ability to be a better guesser. This is also something family members can do for the person with diabetes to help out with carb counting. See Chapter 8 for more information on using a food scale.
Another reliable nutrient database can be found in the USDA Food Composition Databases at https://ndb.nal.usda.gov/ . They provide the details per 100 grams of the food’s weight. When converting the weight of your food, keep in mind that there are 28 grams to an ounce.
Having a Carb-Counting Contest
When a child, teen, or young adult has diabetes, transferring the carb-counting skill set from adult to offspring is a worthwhile teaching process. Otherwise, when kids take off for college and parental support isn’t readily available, they may be in for a rude awakening.
One strategy to get everyone involved in carb counting is to make a game out of it. Why not have a carb-counting contest? For example, each person at the family meal serves up his own starch portion such as pasta or rice, and then everyone eyeballs his plate and announces his guess. After all estimates are announced, the carb foods are scooped into a measuring cup to assess the actual carb count. Set up a reward in advance, such as “Whoever guesses closest doesn’t have to do the dishes or take out the garbage.” I’ll tell you what; everyone improves carb-counting skills real fast.
Making Better Breakfast Choices
Start your day right by choosing wisely for the morning meal. Steer clear of breakfast options that are loaded with sugar and fat. Try the following ideas (and see Chapter 19 for some breakfast menus):
· Check Nutrition Facts labels on cereal boxes (see Chapter 7 for help) and choose brands with less sugar. Deep down inside I think most of us realize that a neon-colored cereal probably isn’t the best choice. Try to limit the sugar in cereal to less than 6 grams per serving (the lower the better). Choose cereals with 3 or more grams of fiber.
· Opt for the oats you cook yourself rather than the instant varieties, but if you do buy instant, choose plain instead of sweetened.
· Skip the Danish, sticky buns, and anything frosted. Try whole-grain toast with jam instead.
· Have a carton of yogurt; compare labels to assess carb counts, fat content, and calories.
· Whole-grain toaster waffles aren’t bad, but skip the syrup. There are nearly 60 grams of sugar per ¼ cup of syrup. You can limit the carbs in the toppings to 15 grams or less if you top waffles or pancakes with ½ cup of applesauce or yogurt, or a cup of strawberries and a little whipped topping.
· As for the meats, limit bacon and sausage, which are full of saturated fat, and choose lean ham, Canadian bacon, or vegetarian links instead.
· Replace juices and smoothies with a cup of fresh fruit. Sweeten coffee and tea with a nonnutritive sweetener rather than sugar.
Packing Your Own Lunch
Packing your own lunch from home to bring to work or school makes it so much easier to control your carb intake. You can measure it all out at home and count carbs precisely. Use ice packs for perishable foods and keep hot foods hot in a thermos. If you want to keep it easy, check your local supermarket for prepared salads, or healthy fresh or frozen meals that can be microwaved (many have Nutrition Facts labels). Head to Chapter 20 for a number of lunch menu ideas.
Choosing Wisely at the Deli
Perhaps you want to grab lunch at your local deli. No problem! Here are some tips for eating at the deli while watching your carb intake:
· Delis have food scales. Ask them to weigh your roll before making your sandwich. Bread has about 14 grams of carb per ounce. Many deli-sized rolls used for sandwiches weigh about 4 ounces, which would count as 56 grams of carb (14 grams of carb multiplied by 4).
· The meat, cheese, mustard, mayo, and crunchy veggies don’t really contribute much carb. Skip fatty meats like salami and bacon and choose chicken, turkey, ham, or lean roast beef. Or make it a veggie sandwich with avocado.
· If you find yourself reaching for a bag of chips, opt for a small bag of baked chips. If you want a side dish, consider a green salad or a piece of fresh fruit.
· Choose diet drinks or unsweetened iced tea rather than sugary beverages.
Considering the Condiments
All too often the carb content of condiments and sauces is ignored when it should be counted. While a swipe of ketchup across a bun is insignificant, having ¼ cup of ketchup with your fries is not; it contributes about 15 grams of carb. Two tablespoons of barbeque sauce can pack in 20–25 grams of carb. Don’t forget to count the spaghetti sauce; it varies, but has roughly 15 grams of carb per ½ cup.
When using insulin-to-carb ratios (see Chapter 6 ), you should be as accurate as possible with your carb counting; otherwise, your dose may be incorrect. Nothing is as frustrating as doing 95 percent of the work and not achieving the blood-glucose result you were hoping for. Don’t be sabotaged by the sauces! Check the Nutrition Facts food labels or use your computer’s search engine to do a search for the carb count. You can also download an app that provides carb counts so you can make an educated guess. (Check out Chapter 9 for more about online resources and apps. See Chapter 8 for tips on creating a carb-counting cheat sheet where you can keep track of the carbs in sauces for future reference.)
Fitting in a Favorite Dessert
Sugar-free gelatin is a freebie that you can have anytime you want. Add a dollop of whipped topping and decorate with a sliced strawberry if desired. There are other desserts that may satisfy your sweet tooth with just 15 grams of carb or less. Read labels on packaged puddings, cookies, and frozen desserts. The trick is to limit yourself to a small serving and not go back for more.
On special occasions, you may want something more carb intense. If you know you want to fit in a dessert with 30–45 grams of carb, it makes sense to have it after a low-carb meal. Tolerating a small piece of cake is much easier after a meal that’s low in carbs such as a chicken Caesar salad or a couple of tacos. Controlling blood-glucose levels is not so easy if you have tiramisu after a plate of pasta and garlic bread. If chocolate is calling your name, limit yourself to just one or two pieces from the box of chocolates, or buy the fun-size treats and don’t go back for seconds. See Chapter 13 for more tips on fitting in reasonable desserts.
Planning and Portioning Snacks
If you don’t pre-plan snacks and bring appropriate options with you, you place yourself at the mercy of whatever you can grab while you’re out. Snacks can end up being too high in calories, carbs, fat, and sodium if you aren’t careful. Finding a healthy snack isn’t always easy when you’re choosing from vending machines, convenience stores, and coffee shops.
Some snack foods come in single-serve packages, such as small packets of almonds, mini boxes of raisins, or individual bags of baked chips. Buying family-sized bags offers cost-savings benefits. The downside is that it may be hard to control how much you end up eating, especially if you’re snacking directly from the bag. Use small zip-lock baggies to separate the multi-serve packages into single servings. Use a permanent marker to write the carb count on each baggie. Pack your pantry with pre-portioned snacks. Keep carrots, other raw vegetables, and fruits handy for snacking. Other items you can bring with you include yogurt, string cheese, hard-boiled eggs, and crackers. Flip to Chapter 22 for more snack ideas.
Curbing Late-Night Snacking
Late dinners and evening snacking can raise blood-glucose levels unless you walk it off or fit in some exercise. Glucose levels may remain elevated throughout the evening and even overnight and into the next day. Evenings are often times of relaxation. Snacking in front of the television or simply out of boredom can derail diabetes and weight-control efforts.
Eat dinner at least three to four hours before going to bed and limit evening snacking to something small. Popcorn isn’t a bad choice. A three-cup portion has only 15 grams of carb.