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TARGET THERAPY

Staying on Target

Carb Counting...Eat to Win!

 What is “Carb” Counting?
Carb (carbohydrate) Counting is a meal planning method
for people with diabetes. It is a way to count the carb
grams or servings in meals and snacks. By evenly spacing
carb foods through the day and by eating about the
same amount at each meal or snack you get better blood
sugar control so you can stay within your blood sugar
targets. You can also enjoy a greater variety of meal
and snack choices. Carb Counting can be basic or
advanced and is a good meal planning system for
anyone with diabetes.

Why Should I Count Carbs?

Food contains many nutrients such as carb, protein, fat,

vitamins, minerals, and water. Carb, protein and fat
supply the calories in foods that give
you energy. Years of research show that
carb is the nutrient that has the most
effect on your blood sugar. In fact, 90 to
100 percent of the carbs you eat appears
in your bloodstream as blood sugar
within a few hours after you have eaten.
Protein and fat have much less effect
on your blood sugar. A healthy diet includes a balance
of carbs, protein and fat.

What is Carb?
Carb foods are very important to a healthy meal plan.
They give us energy as well as vitamins, minerals, and
fiber. Foods that provide most of their calories from
carbs include fruit, milk, sugar, sweets, breads, cereals,
rice, and pasta as well as starchy vegetables such as corn,
1
peas, potatoes, and dried beans. Carbs break down
into sugar and are released into the blood stream.

What Kind of Carb Do I Need?

Many studies have shown that all types
of carb foods affect blood sugar in the
same way. It is the amount of carb you
eat during a meal or snack that is
important, not the type of carb.1
For example: If you have one cup of
vanilla ice cream that has 30 grams of
carbs and a sandwich with 30 grams of carbs, both
will affect blood sugar levels in the same way.

Are Some Carbs Better for Me?

To eat as healthily as you can, you should eat the more
nutritious high-fiber carbs like whole grains fruits and
vegetables including legumes (peas, beans, etc.). Some
sweets can be included in your meal plan but should be
limited. They often are high in fat and include few
nutrients like vitamins, minerals, or fiber. Carb Counting
will help you decide how to include sweets in your meal
plan. Be aware that “sugar-free” foods may still contain
a large amount of carbs.
For example: Sugar-free apple pie will contain carbs from
the apples and the crust. Sugar-free ice cream will have
carb from milk.
1
American Diabetes Association Clinical Practice Recommendations 2002, Evidence-
Based Nutrition Principles and Recommendations for the Treatment and Prevention
of Diabetes and Related Complications, Diabetes Care, January 2002, Supplement 1,
vol.25, p S50.

2
 Carb-Containing Foods
• Fruit, fruit juices (or any food that contains
fruit or fruit juices)
• Milk, ice cream, yogurt (or any food
that contains milk)
• Breads, cereals, crackers, grains,
pasta, rice
• Starchy vegetables (such as corn,
potatoes, peas or beans)
• Non-starchy vegetables (such
as broccoli and salad greens
that contain very small
amounts of carb)
• Sweets (such as cake,
candy, cookies, pie)
• Sugary foods (such as regular soda,
fruit drinks, sherbet)

How Do I Count Carb?

Carb can be counted by either carb servings / choices or
by carb grams. A gram (g) is a unit of measure used for
foods. One carb serving/choice equals 15g of carb. Either
method can be used but however you count carb, you
will also need to learn and recognize portion sizes.

What is Basic Carb Counting?

With Basic Carb Counting, your carb choices can change
from day to day as long as the totals for your meals and
snacks are about the same. (You do not have to eat the
same foods or meals everyday, but you need to eat the
same amount of carb at each meal). Being consistent
is the key to Carb Counting. Eating similar amounts of
carb foods at each meal or snack helps “even out” the

3
ups-and-downs in your blood sugar
level. You can count the amount of carb
you eat as servings, choices or grams.

It is also important to eat balanced

meals with lean protein foods along
with your carb choices. Basic Carb
Counting—along with medication and
exercise—helps keep your blood sugar
levels in your target range so you can
stay as healthy as possible.

Do I Need Advanced Carb Counting?

If you use flexible insulin therapy you can benefit from
Advanced Carb Counting. Flexible management means:
1. Multiple daily insulin injections of
before-meal rapid- or short-acting
insulin or
2. Using an insulin pump and
3. Frequent daily self-monitoring
of blood sugar
In Advanced Carb Counting, mealtime
insulin doses are matched to the amount
of carb you choose to eat. Insulin doses are
based on your current blood sugar level, your
target blood sugar range and the carb amounts
in your meal plan.
Learning how to dose
your insulin builds on
your Basic Carb Counting skills.

4
 Learning The Basics

How Would I Count Carb by the Serving?

You may be familiar with the ADA (American Diabetes
Association and American Dietetic Association) Exchange
Lists for Meal Planning. These lists group
foods according to their nutrients. The
carb-containing food groups include
Bread/Starch, Fruit, Milk and Other Carbs.
The foods in these groups contain about
15 grams of carb per serving. Therefore,
one carb choice equals 15 grams of carb.
The following servings are each one carb choice equaling
15 grams of carb, so each of these choices will affect
your blood sugar level the same:
• 1/2 cup orange juice from the Fruit Group
• 3/4 cup of cereal from the Bread/Starch Group
• 1 cup of milk (12 grams of carb) from the Milk Group.
Twelve grams of carb is equal to one carb choice.
For example: Whether you drink a 1/2 cup of orange juice
(one carb choice) or 3/4 cup of cereal (one carb choice)
or one cup of milk (one carb choice) each food choice
will affect your blood sugar about the same because
each contains equal amounts of carb. All carb-containing
foods are counted equally. Learning the serving size of
each item in the carb-containing food groups will help
you count your carb servings at meals and snacks.
Remember: 15 g of carbs = 1 carb serving or carb choice.

5
Carb Amounts in the Exchange Lists for Meal Planning

Food Carb Grams

Exchange Group Per Item Carb Servings

Starch/Bread 15 g carb 1 carb serving or choice

Fruit 15 g carb 1 carb serving or choice
Milk 12 g carb 1 carb serving or choice
Other Carbs 15 g carb 1 carb serving or choice
Vegetable 5 g carb 1/3 carb serving or choice
Meat/Meat Substitute 0 g carb 0 carb serving or choice
Fat 0 g carb 0 carb serving or choice

You may have an Exchange List meal plan from your

dietitian that suggests specific amounts of carb servings
for each meal and snack. Keep in mind that different
sized portions of fruit, starch, milk, grains, etc. contain
different amounts of carb. What you consider a portion
may actually count as more than one carb serving.
For example: one carb serving of pasta is 1/3 cup (15 g
carb); if you eat 1 cup of pasta, your portion is actually
3 carb servings (45g carb).
How Would I Count Carb by the Grams?
Another way to count carb is to count the number of
carb grams in the portions you eat, and add those
amounts together for a meal or snack total. A gram (g)
is a unit of measure for foods. Your meal plan may
suggest specific amounts of carb grams at each meal
or snack. You will need to become familiar with your
portion sizes and the amounts of carb they contain.
For example: If your portion of pasta is one cup, you
are eating 45 g of carb.

6
 There are many resources you can use to find out how
much carb is in the food you eat, such as:
• The Internet
• Brand Name Food Books
• Bowes and Church's Food Values
of Portions Commonly Used2
• Cookbooks
• Restaurant Item Lists
• The BD Getting StartedTM
Fast Food Guide

What Supplies Do I Need to

Get Started?
Some helpful carb counting tools include:
• “Nutrition Facts” panel on food labels
• Measuring cups for liquids
• Measuring cups for solids
• Measuring spoons
• Food scale
• Calculator

Practice is important. First, measure

your usual food portions. Then,
compare them to the serving sizes
listed on the Nutrition Facts panel
on food labels. It is also a good
idea to compare your portions
with the serving sizes in
the ADA Exchange Lists for Meal
Planning. Knowing portion sizes will
be helpful when you are eating in
a restaurant.
2
Pennington. Jean A.T., Bowes and Church’s Food Values
of Portions Commonly Used. Seventeenth Edition, J.B.
7 Lippincott, Philadelphia. 1997.
How Can I Use Nutrition Facts on Food Labels?
The most common tool for preparing foods at home is
the Nutrition Facts panel. Nearly everything you buy in
grocery stores, except for meats and fresh produce, has
a Nutrition Facts panel on the label. Once you know
what to look for on the label, you will be able to count
carb by the serving or the gram.

To Find the Amount of Carb Servings:

1. Check the product serving size.
In this example it is 1 cup.

2. See the total g (grams) carb

amount for the serving size.
In this example it is 31g. (The
sugars are already accounted
for in the total carb amount.)

3. Find the dietary fiber amount

for the serving size. If a food
you are planning to eat has
five or more grams of fiber
per serving, subtract the grams
of fiber from the total carb
grams in the meal. Fiber is a
carb that is not absorbed by
the body, so high fiber foods
have less of an effect on
blood sugar levels.

For example: One cup of cooked oatmeal has

25 g of carb and six g of dietary fiber. The total
available carb is 19 g (25g minus 6g) or one
carb serving.3

3
Warshaw, Hope S. and Bolderman, Karen M., Practical Carbohydrate Counting: A
How to guide for Health Professionals. American Diabetes Association, 2001, p.43 8
 4. Find the number of carb servings or choices by dividing
the total g carb by 15. In this example it is 2 (31 g
divided by 15 equals 2.06, round to 2). One serving of
this product is equal to two carb servings or choices.
5. Measure your portion. How does it compare to the
serving size on the label? How many carb servings
is your portion?
For example: If you eat one cup your portion is two
carb servings.
6. Add up the total amount of the
other carb foods you are eating.
That will give you a total amount of
carb servings for that meal or snack.

TO COUNT CARB SERVINGS:

Grams of Carb Count as the following
Carb Servings

0 to 5 g Do not count
6 to 10 g 1/2 carb serving or choice
11 to 20 g 1 carb serving or choice
21 to 25g 1 1/2 carb servings or choices
26 to 35 g 2 carb servings or choices

To Find the Amount of

Carb Grams:
1. Find the product serving size. In this example, it is 1 cup.
2. Look at the total carb amount for the serving size. In
this example, it is 31g. One cup of this product contains
31g carb. The sugars are already accounted for in the
total carb amount, so you do not have to count them.

9
 If a food you are planning to eat has 5 or
more grams of fiber per serving, subtract
the grams of fiber from the total
carbohydrate grams in the meal.
3. Measure your portion. How does
it compare to the serving size on
the label? How many servings
is your portion?
4. Multiply your number of servings
times the grams of carb per serving.
One serving of this product is one cup and
has 31 g of carb. If you are eating 1 1/2 cup, multiply
1 1/2 times 31. This equals 46 1/2 grams of carb
(round to 47g). One- and-one-half cups of this
product would equal 47 grams of carb.
5. Get the total amount of carb for that meal or
snack by adding the amounts of the other carb
foods you are eating.

How Much Carb Do I Need?

Everyone needs a different amount of carb. The

amount that is best for you depends on your age,
height, weight, level of physical activity, current blood
sugar level, and your blood sugar
targets. Most people start with 3 or 4
carb servings (45 to 60 g) at each meal
and 1 or 2 carb servings (15 to 30 g) for
snacks. Your dietitian can help provide
the amounts that would be best for you.

10
 Sample Menu
FOOD/BEVERAGE CARBOHYDRATE GRAMS

BREAKFAST
1/2 cup orange juice __________________________________________15
2 slices (2 oz.) whole-wheat toast ______________________________30
1 soft-cooked egg _____________________________________________0
2 tsp. Margarine ______________________________________________0
12 oz. coffee __________________________________________________0
1 pkg. Sweetener _____________________________________________3
Total grams carbohydrate: ____________________________________48

LUNCH
2 slices (2 oz.) rye bread_______________________________________30
2 oz. sliced turkey _____________________________________________0
2 lettuce leaves ______________________________________________<1
1 tsp. mayonnaise _____________________________________________0
1 small bag (3/4 oz.) pretzels __________________________________15
1 small (4 oz.) apple __________________________________________15
12 oz. diet cola soda ___________________________________________0
Total grams carbohydrate: ____________________________________60

MID-AFTERNOON SNACK
16 oz. diet iced tea ____________________________________________0
1/2 c. frozen yogurt___________________________________________15
Total grams carbohydrate: ____________________________________15

SUPPER/DINNER
1 c. tossed salad greens, cucumber slice _________________________5
1 Tbsp. salad dressing__________________________________________0
3 oz. baked chicken breast _____________________________________0
1/2 c. mashed potato _________________________________________15
1/2 c. sliced carrots_____________________________________________5
1 small (1 oz.) dinner roll _____________________________________15
1 tsp margarine _______________________________________________0
2” brownie square ___________________________________________15
12 oz. diet caffeine-free cola soda ______________________________0
Total grams carbohydrate: ____________________________________50

BEDTIME SNACK
1/2 c. juice-packed fruit cocktail _______________________________15
2 small (2/3 oz.) sandwich-type creme filled cookies _____________15
10 peanuts____________________________________________________0

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Total grams carbohydrate: ____________________________________30
What Should I do About Protein and Fat?
Counting carb servings or grams does not mean you
should ignore protein and fat in your diet. Meat and
meat substitutes contain protein and fat, which are
also essential nutrients. But eating too many servings
of protein and fat can lead to weight gain and other
health problems, including high cholesterol.

Most active adults should aim for a total of about 6 oz.

of cooked meat or meat substitutes per day. Choosing
very lean or lean meats over medium- to high-fat meats
are healthier options. This can be divided between your
meals. A simple way to plan this is to have one small
serving at lunch, and one medium-sized serving at supper.
A 3 oz. serving is about the size of a deck of cards.

Fats that are considered more “healthy”

are liquid at room temperature. Limit
the use of fats. Most of your fat intake
should be unsaturated fat such as olive,
canola, or peanut oils, nuts, seeds, or
avocado. Limit your amounts of saturated
fats like butter, bacon, cream, solid
shortenings, and high-fat meats. Ask your
dietitian for help.

12
 Can I Have Alcohol?
Always use caution when drinking alcohol! Pure alcohol,
such as gin, rum, vodka, or whiskey and most wines do
not contain carb, but do have calories.
Research has shown that drinking
alcohol can cause low blood sugar
(hypoglycemia).4 At first, blood sugar
may increase; especially if the drink
contains carb (beer, wine or some mixed
drinks), but blood sugar could drop
several hours after drinking. To prevent
low blood sugar, always eat food,
especially carb, if you drink alcohol.
It is generally recommended that you
limit your alcohol to one or two drinks, one to two
times per week. One drink is equal to:
• 12 oz. light beer (regular beer contains about
15 grams of carb)
• 5 oz. Wine
• 1.5 oz. glass of pure alcohol (distilled spirits)
If you drink alcohol, check your blood
sugar regularly to watch the effects.
You should check your blood sugar
before and several hours after a drink
to determine the effect of alcohol on
your blood sugar. When mixing drinks
with carb-containing liquids like orange
juice you need to count the carb in
the mix.5
4
American Diabetes Association Clinical Practice Recommendations 2002, Evidence-Based
Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes
and Related Complications, Diabetes Care, January 2002, Supplement 1, vol.25, p S55.
5
Franz, Marion J. and Bantle, John P. Editors. American Diabetes Association Guide to
13 Medical Nutrition Therapy for Diabetes. Clinical Education Series P. 202-204. 1999.
Advanced Carb Counting

Why do I Need to Keep Records?

Once you’ve learned the basics of carb counting, you’re
ready for Advanced Carb Counting. It is important to
understand how your carb intake, insulin doses, and
other factors affect your sugar levels. To do this you will
need to keep four different kinds of records for several
days or weeks.

1. Food and drink records

• Name of food or drink ____________________
• Portion size ____________________
• Carb grams in your portions ____________________
• Alcohol intake ____________________
2. Insulin dose records
• Kind of insulin ____________________
• Time of dose ____________________
• Amount of dose ____________________
3. Self-monitoring of blood sugar records
• Fasting blood sugar level ____________________
• Pre-meal blood sugar level ____________________
• Two-hour after-the-start-of-
the-meal blood sugar level ____________________
• Bedtime blood sugar level ____________________
4. Records of other factors that can affect
your blood sugar level
• Physical activity ____________________
• Illness ____________________
• Stress ____________________
• Low blood sugar and amount
and type of treatment used ____________________
14
 What is Pattern Management?
To identify your blood sugar patterns you will need
to look over your records. A pattern is a trend in your
blood sugar levels over a length of time. Many blood
glucose meters have software that can assist you in seeing
these trends in blood sugar. “Pattern management” is
changing your diabetes care so you can stay within your
blood sugar targets. This could mean adjusting your:
• Meal plan
PIE CHART – ALL BLOOD SUGAR READINGS
• Amount of insulin
• Level of physical activity 24.5% Above 9 mmol/L

For example: You may see that 62.0%

In Target 4-8 mmol/L

your blood sugar levels are above

13.5% Below 4 mmol/L
or below your targets at certain
times of day or after eating
certain foods. Once you notice a trend that needs
correction, you can make the necessary changes.

What is An Insulin-to-Carb Ratio?

This is the amount of rapid- or short-acting insulin
you need to match, or “cover,” the amount of carb
you have eaten. Your ratio depends on how sensitive
you are to insulin. The more sensitive you are, the more
carb you will need. Knowing your ratio and how to
dose your mealtime insulin to match your carb intake
will give you the most flexibility with improved
blood sugar control.
mmol/L TREND CHART – BLOOD SUGAR
17

14

12

May May May May May June June June June June June June June June June June
15 22 24 26 28 30 1 3 5 7 9 11 13 15 17 19 211717*17
 5. A good starting point for most adults might be a
ratio of 1:10. Children and insulin-sensitive people
generally use a 1:10 or 1:15 insulin-to-carb
ratio. Everyone is different and it may
take some time to see what works best
for you. Your diabetes educator can help
you find the insulin-to-carb ratio that
is right for you.

Why is the Insulin Sensitivity

Factor (ISF) Important?
Your ISF is the amount of blood sugar (in mmol/L) reduced
by one unit of rapid- or short-acting insulin over two
to four hours. The ISF helps decide how much insulin
you need to get elevated blood sugar back in your
before-meal blood sugar target range. Your ISF should
be tailored for your needs. Ask your doctor to give you
your ISF. Trial-and-error and keeping detailed records
will help you find your ISF. Typically, adults use an ISF
of about 3 mmol/L, while children and insulin-sensitive
adults use an ISF of 1.5 to 3 mmol/L. Everyone is different.

How Can I Figure Out My Correction Dose of Insulin?

Once you know your ISF, you can use it to calculate your
correction dose (supplemental dose) of insulin. Depending
on when you check your blood sugar level, you may be
advised by your physician to add your correction dose
to your pre-meal insulin dose, or to take your correction
dose three or four hours after
your meal.

17
 Things to Remember

A healthy diet is a balance of carb, protein, and fat.

For most adults, this includes about two to four servings
from the milk group each day. Choose fewer salty and
high fat foods, and include fiber-containing foods.
There are many ways to learn the carb gram amounts
of your favorite foods. Read labels, ask
for nutrition information when eating
out and check with your dietitian. Carb
Counting can be a successful meal
planning approach to help manage
your diabetes. With time and
practice, you will become an expert.
The benefits of more flexibility and
better blood sugar control will result
in a winning effort!

For basic guidelines, each food

portion listed contains about 15 g of carb and
counts as one carb serving, unless
noted otherwise.

19
Carbohydrate Servings

Starch
Breads, Cereals and Grains, Starchy Vegetables, Crackers and Snacks,
Beans, Peas, and Lentils, and Starches Prepared with Fat

One serving = 15 g carbohydrate or 1 carbohydrate serving

FOOD SERVING SIZE

BREAD
Bagel, 4 oz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/4 (1oz)
Bread, white, whole-wheat,
pumpernickel, rye, unfrosted raisin . . . . . . . . . . . . . . . .1 slice (1oz)
English muffin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2
Hot dog or hamburger bun . . . . . . . . . . . . . . . . . . . . . . . . .1/2 (1oz)
Muffin, 5 oz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/5 (1oz)
Pancake, 4 in. across, 1/4 in. thick . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Pita, 6 in. across . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2
Roll, plain, small . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 (1oz)
Tortilla, corn or flour, 6 in. across . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Tortilla, flour, 10 in. across . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/3
Waffle, reduced-fat, 4 in. square or across . . . . . . . . . . . . . . . . . . .1

CEREALS AND GRAINS

Bran cereals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Cereals, cooked . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Cereals, unsweetened, ready-to-eat . . . . . . . . . . . . . . .3/4 cup
Granola, low-fat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/4 cup
Grits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Oats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Pasta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/3 cup
Puffed cereal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 1/2 cups
Rice, white or brown . . . . . . . . . . . . . . . . . . . . . . . . . . .1/3 cup
Sugar-frosted cereal . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup

20
 STARCHY VEGETABLES
Baked beans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/3 cup
Corn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Corn on cob, large . . . . . . . . . . . . . . . . . . . . . . . .1/2 cob (5 oz)
Mixed vegetables with corn, peas, . . . . . . . . . . . . . . . . . .1 cup
Peas, green . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Potato, boiled . . . . . . . . . . . . . . .1/2 cup or 1/2 medium (3 oz)
Potato, baked with skin . . . . . . . . . . . . . . . . . .1/4 large (3 oz)
Potato, mashed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Squash, winter (acorn, butternut, pumpkin) . . . . . . . . . .1 cup
Yam, sweet potato, plain . . . . . . . . . . . . . . . . . . . . . . .1/2 cup

CRACKERS AND SNACKS

Graham crackers, 2 1/2 in. square . . . . . . . . . . . . . . . . . . . . . 3
Popcorn (popped, no fat added or low-fat microwave) . . . . 3 cups
Pretzels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3/4 oz
Rice cakes, 4 in. across . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Saltine-type crackers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Snack chips, fat-free (tortilla, potato) . . . . . . . . .15–20 (3/4 oz)
Whole-wheat crackers, no fat added . . . . . . . . . . . 2–5 (3/4 oz)

BEANS, PEAS, AND LENTILS

(also contain about 7 g protein per serving and 5-7g fiber)
Beans and peas (garbanzo, pinto, kidney,
white, split, black-eyed), lentils . . . . . . . . . . . . . . . . . . . . .1/2 cup
Lima beans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2/3 cup

STARCHY FOODS PREPARED WITH FAT (about 5 g fat per serving)

Biscuit, 2 1/2 in. across . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Chow mein noodles . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Corn bread, 2 in. cube . . . . . . . . . . . . . . . . . . . . . . . . . .1 (2 oz)
Croutons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup
Granola . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/4 cup
Popcorn, microwave . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 cups
Sandwich crackers, cheese or peanut butter filling . . . . . . . . . . 3
Snack chips (potato, tortilla) . . . . . . . . . . . . . . . . 9–13 (3/4 oz)
Stuffing, bread (prepared) . . . . . . . . . . . . . . . . . . . . . . .1/3 cup
Taco shell, 6 in. across . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Waffle, 4 in. square or across . . . . . . . . . . . . . . . . . . . . . . . . .1
21
Fruit and Fruit Juices
One serving = 15 g carbohydrate or 1 carbohydrate serving

FOOD SERVING SIZE

FRUIT
Fresh fruit, 1 small . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 (4oz)
Canned fruit, unsweetened . . . . . . . . . . . . . . . . . . . . . .1/2 cup
Dried fruit, unsweetened . . . . . . . . . . . . . . . . . . . . . . .1/4 cup
Blackberries, blueberries . . . . . . . . . . . . . . . . . . . . . . . . 3/4 cup
Cantaloupe, small . . . . . . . . .1/3 melon (11 oz) or 1-cup cubes
Cherries, sweet, fresh . . . . . . . . . . . . . . . . . . . . . . . . . .12 (3oz)
Dates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Grapefruit, large . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 (11oz)
Grapes, small . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 (3 oz)
Honeydew melon . . . . . . . . . . . . .1 slice (10 oz) or 1 cup cubes
Pineapple, fresh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3/4 cup
Plums, small . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 (5 oz)
Raisins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Tbsp
Raspberries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup
Strawberries . . . . . . . . . . . . . . . . . . . . .1 1/4 cup whole berries
Tangerines, small . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 (8 oz)
Watermelon . . . . . . . . . . .1 slice (13 1/2 oz) or 1 1/4 cup cubes

FRUIT JUICE
Apple juice/cider, grapefruit juice,
orange juice, pineapple juice . . . . . . . . . . . . . . . . . . . .1/2 cup
Cranberry juice cocktail, 100% fruit juice blends,
grape juice, prune juice . . . . . . . . . . . . . . . . . . . . . . . . .1/3 cup
Cranberry juice cocktail, reduced-calorie . . . . . . . . . . . . .1 cup

22
 Milk
One serving = 12–15 g carbohydrate or 1 carbohydrate serving

FOOD SERVING SIZE

Fat-free, 1/2%, 1%, 2%, whole, sweet acidophilus . . . . .1 cup

Buttermilk, low-fat or fat-free . . . . . . . . . . . . . . . . . . . . .1 cup
Chocolate, reduced fat or whole . . . . . . . . . . . . . . . . . .1/2 cup
Dry, fat-free . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/3 cup dry
Evaporated, fat-free or whole . . . . . . . . . . . . . . . . . . . .1/2 cup
Soymilk, fat-free, low-fat, reduced fat . . . . . . . . . . . . . . .1 cup
Yogurt, plain or sweetened w/nonnutritive sweetener . . . 1 cup
Yogurt, plain low-fat or made from whole milk . . . . . . . .1 cup
Yogurt, flavored and sweetened with fructose . . . . . . . 3/4 cup

Non-starchy Vegetables
One serving = 5 g carbohydrate
One serving is free. Three servings = one carbohydrate serving
or choice (15 grams of carbohydrate).
One serving of a non-starchy vegetable is:
1 cup raw:
1/2 cup cooked:

Artichoke Green onions Salad greens

Artichoke hearts or scallions (endive, escarole,
Asparagus Greens (collard, lettuce, romaine,
kale, mustard, spinach)
Beans (green,
wax, Italian) turnip) Sauerkraut
Bean sprouts Kohlrabi Spinach
Beets Leeks Summer squash
Broccoli Mixed vegetables Tomato
(w/o corn, peas, Tomatoes, canned
Brussels sprouts
pasta) Tomato sauce
Cabbage
Mushrooms Tomato/vegetable
Carrots
Okra juice
Cauliflower
Onions Turnips
Celery
Pea pods Water chestnuts
Cucumber
Peppers (all varieties) Turnips
Eggplant
Radishes

23
Sweets and Desserts
1 carbohydrate serving = 15 g carbohydrate
2 carbohydrate servings = 30 g carbohydrate
3 carbohydrate servings = 45 g carbohydrate

These foods are listed according to how many carbohydrate

and fat servings they contain.
FOOD SERVING SIZE SERVINGS

Angel food cake, unfrosted . . . .1/12th cake (about 2oz) . . . . . . . . . . . . . 2 carbs

Brownie, small, unfrosted . . . . .2in. square (about 1oz) . . . . . . . . .1 carb, 1 fat
Cake, unfrosted . . . . . . . . . . . . . 2in. square (about 1oz) . . . . . . . . .1 carb, 1 fat
Cake, frosted . . . . . . . . . . . . . . . 2in. square (about 2oz) . . . . . . . . 2 carbs, 1 fat
Cookie or sandwich cookie
with creme filling . . . . . . . . . . . . . 2 small (about 2/3 oz) . . . . . . . . . .1 carb, 1 fat
Cookies, sugar-free . . . . . . . . . 3 small or 1 large (3/4–1oz) . . . . .1 carb, 1–2 fats
Cupcake, frosted . . . . . . . . . . . . . .1 small (about 2oz) . . . . . . . . . . 2 carbs, 1 fat
Doughnut, plain cake . . . . . . . . . .1 medium (1 1/2oz) . . . . . .1 1/2 carbs, 2 fats
Doughnut, glazed . . . . . . . . . . . . 3 3/4 in. across (2oz) . . . . . . . . 2 carbs, 2 fats
Fruit juice bars, frozen,
100% juice . . . . . . . . . . . . . . . . . . . . . . .1 bar (3oz) . . . . . . . . . . . . . . . . . . .1 carb
Fruit spreads, 100% fruit . . . . . . . . . . . .1 1/2 Tbsp . . . . . . . . . . . . . . . . . . .1 carb
Gelatin, regular . . . . . . . . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . . . . . . . .1 carb
Granola or snack bar,
regular or low-fat . . . . . . . . . . . . . . . . .1 bar (1oz) . . . . . . . . . . . . . . .1 1/2 carbs
Honey . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp . . . . . . . . . . . . . . . . . . . . .1 carb
Ice cream . . . . . . . . . . . . . . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . .1 carb, 2 fats
Ice cream, light . . . . . . . . . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . . .1 carb, 1 fat
Ice cream, low-fat . . . . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . .1 1/2 carbs
Ice cream, fat-free,
no sugar added . . . . . . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . . . . . .1 carb
Jam or jelly, regular . . . . . . . . . . . . . . .1 Tbsp . . . . . . . . . . . . . . . . . . .1 carb
Pie, fruit, 2 crusts . . . . . . . . . . . . . . . . .1/6 pie . . . . . . . . . . . . .3 carbs, 2 fats
Pie, pumpkin or custard . . . . . . . . . . . .1/8 pie . . . . . . . . . . . . 2 carbs, 2 fats
Pudding, regular (made
with reduced-fat milk) . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . . . . . 2 carbs
Pudding, sugar-free or
sugar-free and fat-free . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . . . . . .1 carb
(made with fat-free milk)

24
 FOOD SERVING SIZE SERVINGS

Sherbet, sorbet . . . . . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . . . . . . . 2 carbs

Sports drinks . . . . . . . . . . . . . . . . . . . .8oz. . . . . . . . . . . . . . . . . . . . . .1 carb
Sugar . . . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp . . . . . . . . . . . . . . . . . . . .1 carb
Sweet roll or Danish . . . . . . . . . . . .1 (2 1/2oz) . . . . . . . . . . 2 1/2 carbs, 2 fats
Syrup, light . . . . . . . . . . . . . . . . . . . .2 Tbsp . . . . . . . . . . . . . . . . . . . .1 carb
Syrup, regular . . . . . . . . . . . . . . . . . .1 Tbsp . . . . . . . . . . . . . . . . . . . .1 carb
Yogurt, frozen . . . . . . . . . . . . . . . . . .1/2 cup . . . . . . . . . . . . . .1 carb, 0–1 fat
Yogurt, frozen, fat-free . . . . . . . . . .1/3 cup . . . . . . . . . . . . . . . . . . . .1 carb
Yogurt, low fat with fruit . . . . . . . . . . .1 cup . . . . . . . . . . . . . . . 3 carbs, 0–1 fat

Meat and Meat Substitutes

Most adults should plan to have a total of 4-6 oz. per day.
Each of these servings = 1 oz. meat.
1oz. cooked chicken, turkey, fish, lean beef, pork,
lamb, wild game
1 slice cheese
1/4 cup cottage cheese or tuna
1/2 cup tofu
1 Tbsp peanut butter
1 egg

Fat
Try to limit your fat intake to 3 to 5 servings per day. One
serving = 5 g fat.
One fat serving is:
1 tsp margarine, butter, mayonnaise, oil
1 Tbsp cream cheese, salad dressing, and half-n-half cream,
reduced-fat margarine or reduced fat mayonnaise
1 Tbsp sesame, pumpkin, or sunflower seeds
2 Tbsp sour cream, reduced-fat cream cheese, reduced-fat
salad dressing

25
Combination Foods
These foods have servings from several food groups:

FOOD SERVING SIZE SERVINGS

Spaghetti or pasta sauce, canned . . .1/2 cup . . . . . . . . . . . . . . .1 carb, 1 fat

ENTREES
Tuna noodle casserole, lasagna,
spaghetti with meatballs, chili
with beans, macaroni
and cheese . . . . . . . . . . . . . . . . .1 cup (8oz) . . . . . . . . . . . .2 carbs, 2 meats
Chow mein
(without noodles or rice) . . . . . 2 cups (16oz) . . . . . . . . . . . .1 carb, 2 meats

FROZEN ENTREES AND MEALS

Dinner-type meal . . . . . . . . . . . . .generally 14–17oz . . . . 3 carbs, 3 meats, 3 fats
Pizza, cheese, thin crust . . . . . . . . .1/4 of 10 in. (5oz) . . . . . 2 carbs, 2 meats, 1 fat
Pizza, meat topping, thin crust . . .1/4 of 10 in. (5oz) . . . . 2 carbs, 2 meats, 2 fats
Pot pie . . . . . . . . . . . . . . . . . . . . . . . . . . .1 (7oz) . . . . . . 2 1/2 carbs, 1 meat, 3 fats
Entree or meal with
less than 340 calories . . . . . . . . . . . . about 8–11oz . . . . . . . 2–3 carbs, 1–2 meats

SOUPS
Bean . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup . . . . . . . . . . . . . . . .1 carb, 1 meat
Cream (made with water) . . . . . . . . .1 cup (8 oz) . . . . . . . . . . . . . . .1 carb, 1 fat
Instant . . . . . . . . . . . . . . . . . . . . . . .6 oz prepared . . . . . . . . . . . . . . . . . . .1 carb
Instant with beans/lentils . . . . . . . .8 oz prepared . . . . . . . . 2 1/2 carbs, 1 meat
Split pea (made with water) . . . . . .1/2 cup (4 oz) . . . . . . . . . . . . . . . . . . . .1 carb
Tomato (made with water) . . . . . . . .1 cup (8 oz) . . . . . . . . . . . . . . . . . . . .1 carb
Vegetable beef, chicken noodle,
or other broth-type . . . . . . . . . . . . . .1 cup (8 oz) . . . . . . . . . . . . . . . . . . . .1 carb

26
 FAST FOODS

FOOD SERVING SIZE SERVINGS

Burrito with beef . . . . . . . . . . . . .1 (5–7 oz) . . . . . . . . 3 carbs, 1 meat, 1 fat

Chicken nuggets . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . .1 carb, 2 meats, 1 fat
Chicken breast and wing,
breaded and fried . . . . . . . . . . . . . .1 each . . . . . . . . .1 carb, 4 meats, 2 fats
Chicken sandwich, grilled . . . . . . . . . .1 . . . . . . . . . . . . . . . 2 carbs, 3 meats
Chicken wings, hot . . . . . . . . . . . . .6 (5oz) . . . . . . . . .1 carb, 3 meats, 4 fats
Fish sandwich/tartar sauce . . . . . . . . . .1 . . . . . . . . . . 3 carbs, 1 meat, 3 fats
French-fries . . . . . . . . . . . . . .1 medium serving (5oz) . . . . . . . . . . 4 carbs, 4 fats
Hamburger, regular . . . . . . . . . . . . . . .1 . . . . . . . . . . . . . . . 2 carbs, 2 meats
Hamburger, large . . . . . . . . . . . . . . . . .1 . . . . . . . . . . 2 carbs, 3 meats, 1 fat
Hot dog with bun . . . . . . . . . . . . . . . .1 . . . . . . . . . . . .1 carb, 1 meat, 1 fat
Pizza, individual pan . . . . . . . . . . . . . . . .1 . . . . . . . . . . . . 5 carbs, 3 meats, 3 fats
Pizza, cheese, 1/4 medium (12” round)
thin crust . . . . . . . . . . . . . . . . . . . . . about 6oz . . . . . . . . . . 2 1/2 carbs, 2 meats
Pizza, meat, 1/4 medium (12” round) 2 1/2 carbs
thin crust . . . . . . . . . . . . . . . . . . . about 6 oz . . . . . . . . . . . . . 2 meats, 1 fat
Soft-serve cone . . . . . . . . . . . . . .1 small (5 oz) . . . . . . . . . . 2 1/2 carbs, 1 fat
Submarine sandwich . . . . . . . . . . . .1 sub (6 in.) . . . .1 vegetable, 2 meats, 1 fat,
3 carbs
Taco, hard or soft-shell . . . . . . . .1 (3-3 1/2 oz) . . . . . . . .1 carb, 1 meat, 1 fat

27
Free Foods
These foods contain less than 5 g of carbohydrate and have
less than 20 calories per serving. If a serving size is given, limit
the food to three servings per day.

FAT-FREE OR REDUCED-FAT FOODS

FOOD SERVING SIZE

Cream cheese, fat-free . . . . . . . . . . . . . . . . . . . .1 Tbsp (1/2oz)

Creamers, nondairy, liquid . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp
Creamers, nondairy, powdered . . . . . . . . . . . . . . . . . . . . 2 tsp
Mayonnaise, fat-free . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp
Mayonnaise, reduced-fat . . . . . . . . . . . . . . . . . . . . . . . . .1 tsp
Margarine spread, fat-free . . . . . . . . . . . . . . . . . . . . . . .4 Tbsp
Margarine spread, reduced-fat . . . . . . . . . . . . . . . . . . . . .1 tsp
Nonstick cooking spray
Salad dressing, fat-free or low fat . . . . . . . . . . . . . . . . .1 Tbsp
Salad dressing, fat-free, Italian . . . . . . . . . . . . . . . . . . . 2 Tbsp
Sour cream, fat-free, reduced-fat . . . . . . . . . . . . . . . . . .1 Tbsp
Whipped topping, regular . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp
Whipped topping, light or fat-free . . . . . . . . . . . . . . . . 2 Tbsp

SUGAR-FREE FOODS
Candy, hard, sugar-free . . . . . . . . . . . . . . . . . . . . . . . .1 candy
Gelatin dessert, sugar-free
Gelatin, unflavored
Gum, sugar-free
Jam or jelly, light . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 tsp
Sugar substitutes, alternatives, or replacements*
Syrup, sugar-free . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Tbsp

*FDA (Food and Drug Administration) approved include:

Equal® (aspartame) Sweet-10® (saccharin)
Splenda® (sucralose) Sugar Twin® (saccharin)
Sprinkle Sweet (saccharin)
®
Sweet ’n Low® (saccharin)
Sweet One® (acesulfame K)

28
 FOOD SERVING SIZE

DRINKS
Bouillon, broth, consommé
Bouillon or broth, low-sodium
Carbonated or mineral water
Club soda
Cocoa powder, unsweetened . . . . . . . . . . . . . . . . . . . . .1 Tbsp
Coffee
Diet soft drinks, sugar-free
Drink mixes, sugar-free
Tea
Tonic water, sugar-free

CONDIMENTS
Catsup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp
Horseradish
Lemon juice
Lime juice
Mustard
Pickles, dill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 1/2 large
Salsa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1/4 cup
Soy sauce, regular or light . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp
Taco sauce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Tbsp
Vinegar
Yogurt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Tbsp

SEASONINGS
Flavoring extracts
Garlic
Herbs, fresh or dried
Pimento
Spices
Tabasco® or hot pepper sauce
Wine, used in cooking
Worcestershire sauce

29
 Food Diary
NAME _____________________________________ DATE ___________________

MEAL PLAN GOAL_____________________________________________________

NUMBER OF CARB CHOICES:

Breakfast___________________________________________ carb choices
Lunch_______________________________________________ carb choices
Dinner______________________________________________ carb choices
Snacks______________________________________________ carb choices
Record all the food that you eat for at least 3 days below. This record will
help you and your health care team decide if changes in medication and
or your meal plan should be made.

TIME AMOUNT SNACK/MEAL FOOD EATEN / PREPARATION CARB CHOICES

GOAL:
EXERCISE:
30