So far, we’ve covered carbohydrate counting as the primary method of managing blood sugars. It is by far the most important nutritional factor to pay attention to. There are, however, other lifestyle factors that affect blood sugar and are critical to know.

If you have diabetes, have a family history of diabetes, or just want to promote health and prevent chronic conditions, check out the list below to learn about the types of things that can affect blood sugar aside from your diet:

  • Stress – This one is HUGE. Stress of many kinds raises levels of a hormone called cortisol that raises blood sugar (1). It’s important to keep in mind here that stress is more than mental and emotional stress (bills, relational issues, busy schedules…you get the picture). It also includes physiological stress (think chronic pain, poor sleep quality and/or quantity, infections, illness, etc) that may not come to mind when we think of the word stress. It is important to make a priority of identifying effective methods of managing stress by addressing the roots of these issues.
    • Mental/emotional stress – The “best” methods of stress management vary for each person but good options include yoga, walking, meditation, deep breathing, and enjoyable hobbies. If you struggle with depression, anxiety, or trauma that causes ongoing stress, find a qualified counselor you trust to help you work through these very real and overwhelming conditions.
    • Physiological stress – Pursue the root cause of your physiological stress. If you suffer from chronic pain, discuss pain management options with your doctor (there are many options beyond pain pills!) or talk with a Registered Dietitian who is knowledgeable about methods of eating to reduce inflammation. If you have poor sleep quality, practice good sleep hygiene habits and consider asking your doctor to have a sleep study done (especially if you snore!) to see if you might have a potentially serious condition called sleep apnea.
  • Physical inactivity – Our bodies are designed to move and groove. Doing so activates receptors to let more sugar out of the blood and into the cell to make the extra energy we need for all that movement. My favorite part about the benefit of exercise for blood sugar is that just 30 minutes of moderate exercise (brisk walking, dancing, swimming, biking – whatever you like!) can improve blood sugars for 1-2 days afterward (2). Talk about return on your time investment!
  • Inflammation – Inflammation is a type of stress, so I could have included it under physiological stressors, but it’s such a big deal I felt it deserved its own bullet point. Type 2 diabetes is an inflammatory disease, and inflammation is one of the causes of the insulin resistance that is a precursor to type 2 diabetes. Reducing inflammation through exercise, anti-inflammatory eating, and achieving a healthful weight can significantly improve blood sugars (3).

Medications – Certain medications can raise blood sugar significantly in some people. This typically resolves after they stop taking the medications, but not always. For people with diabetes, these meds raise blood sugars even farther. Taking these medications is not always avoidable, but if you’re concerned about your blood sugars, check the side effects on any medications you take and discuss them with your doctor.

  1. Aronson, D. (2009) “Cortisol – Its Role in Stress, Inflammation, and Indications for Diet Therapy. Today’s Dietitian, 11(11). Retrieved from http://www.todaysdietitian.com/newarchives/111609p38.shtml
  2. Colberg, SR, et al. (2010) “Exercise and Type 2 Diabetes: American College of Sports Medicine and the American Diabetes Association: Joint Position Statement.” Medicine and Science in Sports and Exercise, 42(12). Retrieved from http://europepmc.org/abstract/med/21084931.
  3. Shoelson S, Lee J, & Goldfine A. (2006) Inflammation and Insulin Resistance.” The Journal of Clinical Investigation, 116. Retrieved from http://www.jci.org/articles/view/29069?search%5Babstract_text%5D=&search%5Barticle_text%5D=&search%5Bauthors_text%5D=&search%5Bfpage%5D=1793&search%5Bissue%5D=&search%5Btitle_text%5D=&search%5Bvolume%5D=116.

Today ends week 1 on carbohydrate counting and I gotta tell ya, this is my favorite “diet” by far. It doesn’t even really feel like a diet. I mean, check out some of the awesome meals I got to eat!

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I think part of the reason it feels easy is that I have taught the principles so many times that I didn’t have much of a learning curve as far as learning how to carb count. I could recite carbohydrate portion sizes in my sleep…as a matter of fact, I probably do. You’d have to ask my husband.

The greatest part about carb counting is that it is not very restrictive IF you are intentional about balancing your plate with non-carbohydrate foods. You can eat pretty much anything, the most important keys are how much and when. There have only been one or two times throughout the week when there was something I wanted more of but I had already run out of carbohydrates. 

Carb counting feels more like a guardrail than a diet – there to guide me in the right direction and keep me from flying off a cliff on a carb binge.

The most difficult part has been boring beverages. Most of the time I would way rather spend my carbohydrates on food than on beverages, which leaves me with tea only rather than tea and juice with breakfast and water instead of milk or a glass of wine with dinner. Overall, not that big of a deal but I have to admit I do miss drinking a glass of milk in the evening.

Here are the details for my first week on carb counting:

  Carb Counting Goal Week #1 Week #2 Week #3
# of days nutrition recommendations met 7 7 (yay!)    
Average carbohydrate intake per meal 45-60 grams 52.4    
Weight change   -2 lb    
Waist change   -.5″    
Grocery Budget Change   +18%  

 

Though this particular meal plan has been very flexible, I’m looking forward to carb counting on my own and seeing how well I can do flying solo!


For a little practice, here is the carbohydrate breakdown for the four meals and two snacks I’ve had so far. Remember that my goal is 45-60 grams carb (3-4 carb portions) per meal and 15 grams carb (1 carb portion) per snack:

Monday Dinner

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3 oz meatloaf = 15 g carb (1 carb portion)

1 small dinner roll = 15 g carb (1 carb choice)

1/2 c. mashed potatoes = 15 g carb (1 carb choice)

1/3 c. cooked carrots = 7 g carb

1 c. green salad = 0 g carb

1 Tbsp light blue cheese dressing = 0 g carb

Total carbs = 52 grams carb                                                                                                              (3.5 carb portions)

 

Tuesday Breakfast
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whole wheat English muffin = 30 g carb (2 carb portions)

1 Tbsp fresh ground peanut butter = 2.5 g carb

1/2 medium banana = 15 g carb (1 carb portion)

green tea (with my awesome Mr. Tea infuser!) with Stevia = 0 g carb


Total carbs = 47.5 grams (3 carb                                                                                                      portions)

 

img_0757

 

 

Tuesday Morning Snack

3/4 oz pretzels = 15 grams carb (1 carb portion)

 

 

 

Tuesday Lunch

img_0759                                                                                                        2 slices whole wheat bread = 30 g carb (2 carb choices)
3 oz. turkey deli meat = 0 g carb

1 slice cheddar cheese = 0 g carb

2 leaves lettuce = 0 g carb

2 slices tomatoes = 0 g carb

1 Tbsp light mayo = 0 g carb

1 tsp Dijon mustard = 0 g carb

1 medium apple = 28 g carb                                                                                                               (2 carb portions)

                                                                                         Total carbs = 58 grams (4 carb portions)

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Tuesday Afternoon Snack

6 oz. light yogurt = 16 grams carb (1 carb portion)

 

 

 

 

Tuesday Dinner

img_0762

1 c. chili w/lean ground beef = 22 g carb (1.5 carb portions)

1 oz. cornbread = 15 g carb (1 carb portion)

1 c. green salad = 0 g carb

1 Tbsp light ranch dressing = 0 g carb

1 Tbsp fat free sour cream = 0 g carb

1 Tbsp Smart Balance            spread = 0 g carb

And I had plenty of carbs left so I topped it off with a square of Ghirardelli dark chocolate (7 g carb)!

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Total Carbs = 44 grams carb (3 carb portions)

So far, so good! The food has been tasty and filling, and I haven’t felt restricted. I’m loving the flexibility of this meal plan!

Comment if you have any questions about how the carb counting works (or about anything else)!


Check out this haul from my first grocery shopping trip for Carb Counting!

Yes, we drink a LOT of milk at our house.

Yes, we drink a LOT of milk at our house.

I think I’m going to like this particular meal plan that I am using because it offers more flexibility than other meal plans I have used in the past. It gives lists of sample breakfasts, lunches/dinners, and snacks and allows me to pick and choose the ones I like, as well as repeat meals to use leftovers, which definitely helps with some of the issues I have with meal plans in general (which I described here).

So I thought I’d start out by describing what carb counting is all about. As described here, eating too many carbohydrates at one time can raise blood sugar too high for someone with diabetes. First thing’s first: which foods have significant amounts of carbohydrates?

  • breads and grains like rice, pasta, and oats
  • beans and legumes
  • starchy vegetables like potatoes, peas, and corn
  • milk and yogurt
  • fruit and fruit juice
  • sugars like sugar, brown sugar, agave, syrup, honey and sugary beverages like soda and sports drinks

These are the foods we primarily “count” as we count carbohydrates. The specific goal for carbohydrate intake varies between individuals based on height, weight, gender, activity levels, and blood sugar control goals. If you have diabetes and don’t know how many carbohydrates you should eat, find a Registered Dietitian who can help you find out.

For me, my goal is going to be 45-60 grams of carbohydrate per meal, 15 grams of carbohydrate per snack, as well as meeting the recommended activity goal of 30 minutes of moderate exercise 5 days per week (This can really help blood sugars! More on that in a future post.)

To help make carb counting easier, something called a “carbohydrate portion” or a “diabetes portion” was introduced. This is basically the amount of any carbohydrate food that contains 15 grams of carbohydrate. You can see some examples of carbohydrate portions in the chart below:

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Chart from www.brighamandwomens.org

As you can see by my carbohydrate counting goals, they are in multiples of 15 grams. So basically, at meals I can select 3-4 “carbohydrate portions” and at snacks I can choose 1. I can then fill in the gaps with non-carbohydrate foods like meat, eggs, cheese, vegetables, nuts, or seeds.

Carb counting can be tricky, but with some practice, awareness, and strategy, most people with diabetes find that they can live a relatively “normal” food life. I’ll see if I can make it happen in these three weeks and, if so, hopefully I can pass some useful info on to you!


No matter how you say it, it’s serious. Diabetes is common and can wreak havoc on someone’s body, so I’m more than happy to spend some time focusing on this condition and how to manage blood sugars by counting carbohydrates.

For anyone who is looking for a review of what carbohydrates are or what they do in the body, check out this post. Carbs are the numero uno focus when it comes to managing diabetes and reducing risk of complications.

To understand how diabetes works, let’s go back to the house/insulin key/sugar explanation I wrote about here. Check it out because my upcoming explanation will likely not make sense if you’re not in on the metaphor. Let’s also bring my highly sophisticated representative drawing back for a second look:

insulin

 In people with diabetes, the sugar people are not able to get into the house, causing a buildup of sugar people in the streets. They get crowded and angry and start flipping cars, breaking windows, and rioting all over the place. It makes for a pretty hostile environment.

This buildup of sugar people in the streets typically happens for one of three reasons:

  1. The person has an autoimmune condition that prevents the body from being able to make insulin keys at all. This is called Type 1 diabetes.
  2. The person’s locks are all rusty and take a long time to open. While the lock and key are fumbling around, sugar people build up in the street. This happens for a variety of reasons including genetics, obesity, stress, and inflammation, among others. This is called Type 2 diabetes.
  3. The person’s locks are temporarily rusty because of the effects of hormones associated with pregnancy. This is called Gestational diabetes and most of the time it goes away after the baby is delivered, though it does increase a woman’s risk of having type 2 diabetes later in life.

 

In order to keep there from being too many angry sugar people in the blood, nutrition recommendations include portioning total amounts of carbohydrates eaten at one time. In other words, we send sugar people into the street single file all polite-like rather than stampeding en masse. That is why, in support of my patients and anyone with diabetes, I will be counting and moderating intake of carbohydrates at each meal and snack starting on Monday. We’ll also be going over more specifics about what types of foods are carbohydrates.

There are several other things we can do to help keep the sugar people from building up and rioting – look for more info in upcoming posts!


So, which diet did you choose for dietitian on a diet to follow next?

 

Photo from islandalpaca.com

Photo from islandalpaca.com

Carb counting for diabetes! That means I’ll be keeping on eye on the types of foods that break down into…*gasp*…SUGAR!!! I’m looking forward to this one for a few reasons:

  1. Diabetes is really common. Scary common. According to the American Diabetes Association, as of 2012 9.3% of the population had diabetes, and about 8.1 million of those were undiagnosed. With nearly 1 in 10 Americans having diabetes, chances are very high you know several people with diabetes.
  2. There are a lot of misconceptions about eating for diabetes. For some reason, the message has come across that eating for diabetes is very restrictive and the portions are teensy. The truth is, it doesn’t have to be that hard. It takes intention and awareness, but it’s not a death sentence for your tastebuds. Promise.
  3. Sugar is the root of all evil. Or so a lot of people say. Therefore, foods that break down into sugar must be evil. Or so a lot of people say. We’ll definitely address that while I’m on this diet.

 

I’ll be delving into this diet starting Monday the 17th – stay tuned if you’re interested in learning how to live with (or support someone who lives with) diabetes!