Carbohydrate Counting and Basic Nutrition An education program for the person with diabetes Presented by: Lisa Cogbill, RD LD CDE

Objectives: Meal Planning What is a Carbohydrate Food Choices Label Reading Importance of Nutrition

Keeping the Body Healthy Nutrition Management of Type 1 Diabetes Mellitus Healthy nutrition provides enough energy (or calories) for growth and development and allows for normal activities of daily living and exercise. Meal planning is part of your everyday life. The key to success is balancing:  Food  Insulin  Exercise Healthy choices with heart healthy meals are good for all individuals with and without diabetes. The needs will vary with age, sex, weight, and activity level.

THE 3 FOOD GROUPS Carbohydrates Proteins Fats Meal planning for type 1 diabetes is based on carbohydrates. Carbohydrates raise blood sugar. In people with type 1 diabetes, we give insulin based on the carbohydrates that are eaten. The total amount of carbohydrates, protein, and fat in the meal plan will vary for individuals.

Protein Protein is a part of every cell in the body. Protein is needed for growth and repair of the body. Important enzymes and hormones are also proteins. Good sources of protein are: Meats Cheeses Nut Butters Both the amount and quality of the protein are important. Fortunately, most individuals in the United States eat enough protein. All individuals need to include carbohydrate, fat, and protein in their diet. For the person with type 1 diabetes, we focus on carbohydrates and knowing how many grams of carbohydrate we eat at meals and snacks.

Fats Fats have an important role in a healthy meal plan. For example, vitamins A, D, E, K and carotenoids are fat-soluble. This means that fat is required for their digestion and absorption. Fats provide energy, which is important for individuals to grow appropriately. Fats keep the brain and nervous system functioning normally and help maintain healthy skin. There are many different types of fat that have different effects on cholesterol and cardiovascular health. Saturated Fat –They are found mainly in animal-based foods such as meat, poultry, butter, whole milk and whole milk products, and from coconut, palm and palm kernel oils. Monounsaturated Fat – Canola oil, olive oil, avocado oil and nuts Polyunsaturated Fats- Corn, safflower, soybean, sesame, sunflower, peanut, walnut, fish, and flaxseed oils

Eat Right Carbohydrates are the primary foods that affect glucose levels. Foods with Carbohydrates Breads, crackers and cereals Pasta, rice and grains Starchy vegetables, such as potatoes, corn and peas Non-starchy vegetables such as broccoli, salad greens and carrots Milk and yogurt Fruits and juices Sweets and desserts

Straight to your blood stream

CARBOHYDRATE COUNTING Carbohydrate counting is important for meal planning when you have diabetes. Knowing how much carbohydrate you eat helps you determine how much insulin you will need. Counting the total grams of carbohydrate in meals and snacks helps you eat about the same amount of food. Eating the same amount of carbohydrate, but from different foods, have an effect on blood sugar.

MASTERING THE SYSTEM After you know what type of foods contain carbohydrates you need to know exactly how much it contains. Food labels, nutrient analysis apps and books, and learning portion sizes are all tools that can help you become accurate.

Tools and tips

Tools and Tips Source: Adapted from Warshaw, H.S., Bolderman,K.M.: American Diabetes Association Practical Carbohydrate Counting: A How-To-Teach Guide for Health Professionals., Alexandria, Va., Copyright © 2001 American Diabetes Association.

Counting carbs: Check the label Serving Size: The portion for which nutritional facts are calculated. Total Carbohydrates: Includes grams of sugar, sugar alcohol, starch, dietary fiber.

How many carbs are in 4 crackers? Calculate a snack How many carbs are in 4 crackers? 4 crackers = 2 servings 2 servings x 10 grams per serving = 20 grams of carbs

Your turn … How much is one serving? How many grams of carbs are in one serving? If you eat one cup, how many carb exchanges is that?

YOUR TURN How many grams of carbs in a 6 inch turkey sub? How many carbs in 60 fries? How many carbs in 1 cup of cooked green beans? How many carbs in 1 cup raw broccoli? How many carbs in 1 piece of bubble gum? How many carbs in Moms homemade Chicken Pot Pie?

Chicken Pot Pie Recipe recipe makes 1 - 9 inch pie 1 pound skinless, boneless chicken breast halves 1 cup sliced carrots 1 cup frozen green peas 1/2 cup sliced celery 1/3 cup butter 1/3 cup chopped onion 1/3 cup all-purpose flour 1/2 teaspoon salt 1/4 teaspoon black pepper 1/4 teaspoon celery seed 1 3/4 cups chicken broth 2/3 cup milk   1 (9 inch) unbaked pie crusts Carb content in recipe 1 cup carrots – 5g 1cup peas – 30 g celery and onion– 5 grams 1/3 cup flour -30 grams 2/3 cup milk – 8 grams 1 pie crust -96 grams Total Carbs = 174 Total serving in pie = 8 Total for 1 serving= 174/8=21.75 22 grams Carbs

You are what you eat. The freedom of carb counting can increase the temptation to overeat—which inevitably leads to weight gain. Remember to eat at least 3-5 servings of vegetables and 2-3 servings of fruit.

RD Visits It is recommended that all people with type 1 diabetes mellitus see a registered dietitian at least once a year. A dietitian can provide specific details on calorie, carbohydrate, and fat needs. They will also provide nutrition counseling to help manage blood sugars and to promote health and wellness

Knowledge is power Any questions? Thank you!!!!