Nutrition Guidelines Implementation Committee
MAKING CARBOHYDRATES COUNT:
A HANDS-ON APPROACH
Presented By:
Barbara Allan RD, CDE
Anne Garrett RD, MEd
Kathryn Arcudi PDt, CDE
Kerry Schubert-Mackey RD, CDE
Making Carbohydrates Count
Basic Carbohydrate Counting for Diabetes Management
Case study: Guy is a pleasant man who has had diabetes for a few years.
After a bit
of discussion, you and he determine that a more flexible meal planning system would
help him control his blood glucose. It is decided that Guy should begin with basic
carbohydrate counting for diabetes management.
1. List the tools/resources that could be used for teaching basic carbohydrate (CHO)
counting. (two minutes)
2. What are the steps in teaching CHO counting? (one minute)
3. Guy brings his detailed food record to follow-up (see attached).
a) Calculate the total carbohydrate intake for Lunch on October 2nd. (5 minutes)
b) How would you go about determining his initial carbohydrate goal for lunches?
4. What will you say to Guy about his habit of consuming diet candy bars? (1 minute)
(6 minutes)
Three Day Food Records For: Guy
Date/Meal
October 1
Breakfast
Food Item/Beverage
Fibre One cereal
2% milk
Banana
Whole wheat bread
Lunch
Supper
Bedtime snack
October 2
Breakfast
Butter
Mustard
Ham
2% milk
Mini carrots
Apple, MacIntosh
Rice, white long grain
Shrimp
Broccoli
Snow peas
Red pepper
Whole wheat bread
Peanut butter
2% milk
Fibre One Cereal
Banana
2% Milk
Pita, whole wheat
Lunch
* see resource
sheets
Supper
Bedtime snack
Beef
Mustard
Tomato soup, made w milk
Soda cracker *, whole wheat
Baked Beans *
Mini carrots
Pear *
Light Crunch Bar *
Spaghetti
Garlic bread, French stick
Homemade spaghetti meat sauce
Parmesan cheese
Iceberg lettuce
Italian dressing
Vanilla Ice cream
Whole wheat bread
Peanut butter
2%milk
Portion
Carb Grams
1 cup
6oz
115 gm
20
9
25
BREAKFAST TOTAL= 54 grams
2 slices (46 gram wt
47 – 5 = 42
each slice)
2 tsp
0
1 tsp
0
2.5 oz
0
8oz
12
10
8
small (135gm)
18
LUNCH TOTAL= 80 grams
1 1/3 cups
80
10 large
0
1.5 cups
9
½ cup
6
160 gram wt
11
SUPPER TOTAL= 106 grams
2 slices
47 – 5 = 42
1 tablespoon
2
8 oz
12
BEDTIME TOTAL= 56 grams
1 cup
20
115 gm
25
6oz
9
BREAKFAST TOTAL= 54 grams
6.5 inch diameter (60g
On web/pkg:
wt)
31 g
2 oz
0
1 tsp
0
8 oz
23
10
1cup
10
8
medium
1 bar
LUNCH TOTAL =
grams
2 cups
84 - 5 = 79
3 slices
25
1.5 cups
15
2 tablespoon
0
1 cup wedge
1
3 tablespoon
3
½ cup
20
SUPPER TOTAL= 143 grams
2 slices
47 –5 = 42
1 tablespoon
2
8 oz
12
BEDTIME TOTAL= 56 grams
…….. 2
Three Day Food Records Cont’d For:
Date/Meal
October 3
Breakfast
Food Item/Beverage
Fibre One cereal
2% milk
Banana
Whole wheat bread
Lunch
Supper
Bedtime
Snack
Butter
Mayonnaise, light
Tuna
2% milk
Celery sticks
Apple, MacIntosh
Baked potato
Green beans, cooked
Cauliflower, cooked
2% Milk
Chicken
BBQ sauce
Sour Cream
Applesauce, unsweetened
Whole wheat bread
Peanut butter
2%milk
Portion
Guy
Carb Grams
20
9
25
BREAKFAST TOTAL= 54 grams
2 slices (46 gram wt
47 – 5 = 42
each slice)
2 tsp
0
1 tablespoon
1
3.5 oz
0
8 oz
12
1 stalk
1
small
18
LUNCH TOTAL= 74 grams
1 large, 200 gm wt
51- 5 = 46
1 cup
10
1 cup
6
8 oz
12
4.5 oz
0
1 tablespoon
1
5 tablespoon
6
½ cup
14
TOTAL SUPPER = 95 grams
2 slices
47 – 5 = 42
1 tablespoon
2
8 oz
12
TOTAL BEDTIME = 56 grams
1 cup
6 oz
115 gm
Carbohydrate Resource Sheet
Guy used three different resources in addition to food labels to look up carbohydrate values for the items he
consumed over the three days.
Resource:
Item
Portion Listed
Carb Grams ____
Pear
(raw with skin)
1 medium
26g – 5 g fibre = 21 g
Baked Beans
(canned)
1 cup
55g – 20 g fibre = 35 g
Soda Crackers
Whole Wheat
not listed – only regular salted tops
Candy Bar
not found
Pear
2.5 ounces
22g
Baked Beans
(homestyle -canned)
8 ounces
52 g – 18 fibre = 34 g
Soda Crackers
(Whole Wheat Premium)
5 crackers
11 g
Candy Bar
not found
Carbohydrate Counter
(raw)
www.carbvalues.ca
Pear
(Raw without skin)
Carbs, carbs and more!
1 small
20 g
Baked Beans
(canned –maple flavour)
½ cup
25 g – 8 g fibre = 17 g
Saltine Whole Wheat
Cracker
10 crackers
23 g
Candy Bar
not found
Carbohydrate Resource Sheet
Example of Label for Guy’s Cracker and Light Crunch Bar
Light Crunch Bar
Premium Whole Wheat Crackers
Per 15 g = Approx. 5 crackers / par 15 g 5 biscuits
Nutrition Facts
Valeur Nutritive
Per/par 1 bar / 1 barre
Amount
Teneur
Amount
Teneur
Nutrition Facts
Valeur nutritive
% Daily Value
% valeur quotidienne
Calories/Calories 66
Calories/Calories 166
Fat /Lipides 1.7 g
Saturated/saturés 0.4 g
+ Trans/trans 0.1 g
3%
0%
Fat/Lipides 9.4 g
Saturated/saturés 3 g
+ Trans/trans 1 g
20%
Sodium/Sodium 2 mg
0%
Carbohydrate/Glucides 30 g
10%
Sodium/Sodium 151 mg
6%
Carbohydrate/Glucides 11 g
3%
Fibre/Fibres 0 g
4%
Sugars/Sucres 6 g
1g
14%
Cholesterol / Cholesterol1 mg
Cholesterol/Cholestérol 0.0 mg
Fibre/Fibres
% Daily Value
% valeur quotidienne
0%
Sugar Alcohols / Polyalcools 5.7 g
Sugars/Sucres 0 g
Protein/Protéines 3.4g
Protein/Protéines 1.8 g
Vitamin A
0%
Vitamin C
2%
Vit A
Calcium
0%
Iron
1%
Calcium 0.5 %
0%
Vit C
0%
Iron/Fer
0%
Ingredients: Polydextrose 17 g, sorbitol 4.2g,
modified palm and vegetable oils, modified
milk ingredients, lactitol 1.5 g, molasses, salt,
cocoa butter, aspartame 53 mg, flour, soya
lecithin, natural and artificial flavour
Basic Carbohydrate Counting for Diabetes Management
Name:
Date:
www.diabetes.ca
What did you eat and drink?
DAY 2
DAY 1
Food & drink taken
Portion size
Grams of Carb
Breakfast
Food & drink taken
Portion size
Grams of Carb
Breakfast
Total Carb:
AM snack
Total Carb:
AM snack
Total Carb:
Lunch
Total Carb:
Lunch
Total Carb:
PM snack
Total Carb:
PM snack
Total Carb:
Supper
Total Carb:
Supper
Total Carb:
Evening snack
Total Carb:
Evening snack
Total Carb:
Total Carb:
Making Carbohydrates Count
Basic Carbohydrate Counting for Diabetes Management
CASE STUDY ANSWER SHEET
1. List the tools/resources that could be used for teaching basic carbohydrate
(CHO) counting.

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




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Basic Carbohydrate Counting for Diabetes Management tear-off
Just the Basics: Healthy Eating for Diabetes Management and Prevention
Canada’s Food Guide to Healthy Eating
Food models to demonstrate foods that contain carbohydrate
Measuring cups and food weigh scale
Basic Carbohydrate Counting for Diabetes Management- What did you eat or drink?
The Good Health Eating Guide Resource
Examples of resources for calculating carbohydrate in foods- books, fast food nutrition information,
food labels, internet web sites.
2. What are the steps in teaching CHO counting?
“Basic Carbohydrate Counting for Diabetes Management” tear-off for Steps 1 to 5
3. Guy brings his detailed food record to follow-up (see attached).
a) Calculate the total carbohydrate intake for Lunch on October 2nd.
Pita 31g + beef 0g +mustard 0g+ tomato soup 23 g +soda crackers 22g
+ baked beans 34g + mini carrots 8g + pear 21g + diet candy bar 11g =
150 g
b) How would you go about determining his initial carbohydrate goal for lunches?
 Review with Guy how to calculate the carbohydrate for his three lunches.
 Show Guy the variation in his lunch carbohydrate intakes (80g vs 74g vs 150g).
 Discuss this variation and together determine a carbohydrate goal that would meet his
needs and provide consistent carbohydrate intake for all lunches. Factors in making a
decision include healthy eating, nutritional needs and Guy’s lifestyle and personal
preferences.
4. What will you say to Guy about his habit of consuming diet candy bars?
See “Making Carbohydrates Count: A Hands-on Approach” powerpoint presentation available on
CDA website or Canadian Journal of Diabetes Vol. 26 (4): pp 356-362
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Taking less than 10 grams of sugar alcohols daily limits the impact on metabolic control and the
risk of gastrointestinal upset.
Be cautious with habitual use of diet candies, diet cookies, or diet chocolates because of their
low nutrition, high expense and potentially high fat content.
Calculate the polyol carbohydrate as half or use formula and chart for more exact calculation.
This presentation, its resources, case study and answers will be posted on the CDA website.