Depending on who you ask, you might find anti-inflammatory recommendations that encourage complete elimination of sugar and carbohydrates to decrease inflammation. As is frequently the case, though, those recommendations are likely unnecessary extremes and everything is case-by-case. For one thing, you can probably achieve the anti-inflammatory benefits you’re looking for while still including well chosen, nutrient dense complex carbohydrates. Secondly, why over-restrict if we can still enjoy some tasty treats in moderation? That’s how we balance meeting health goals and living a life we love! So what does the research actually say about carbs and inflammation?

Multiple studies have linked consumption of concentrated sugar and simple carbohydrate consumption with increased levels of inflammation.1-2 A long time ago I talked in this post about what happens when we eat carbs and how we break them down into blood sugar to use as fuel. Those fuels are stuck in the blood until insulin comes around to let them in to our cells. High blood sugars, especially over the long term, correlate with inflammation in several types of tissue in the body, including fat cells.3

A strong link has been drawn between chronic inflammation and insulin resistance.4 This is a vicious cycle because (as you may remember from this post) insulin resistance means that blood sugars get stuck in the blood without a way out, causing fat storage and inflammation. Stored fat then produces inflammatory factors which make insulin resistance worse! Not fair.

So what can we do about it? Well, we can aim to cut inflammation off at the pass by changing parts of our lifestyle and the foods we eat to combat inflammation and give our cells a helping hand with that blood sugar. With regard to carbohydrates, we can do a couple of things specifically:

  1. Focus on eating more complex carbohydrates than simple carbohydrates like sugar. What does that mean? Well, complex carbohydrates are long chains of sugars that take much longer to digest, break down, and enter our blood, thus making our blood sugar much more stable (and preventing inflammation from blood sugar spikes). Simple carbohydrates are individual sugars or tiny chains of sugars that break down very quickly and enter the blood rapidly, causing a sharp spike in blood sugar that is inflammatory. Complex carbohydrates like whole grains, beans, and vegetables are connected with lower levels of inflammation.5 Same goes for high-fiber carbohydrates like fruit.

Photo from wearewhatweeat1.blogspot.com

 

2. Avoid eating too much carbohydrate at once. Just like with diabetes, the key to preventing carbohydrate-induced inflammation is keeping the blood sugar from going too high. Eating controlled amounts of carbohydrate throughout the day can help keep your energy up and your inflammation down.

  1. http://ajcn.nutrition.org/content/94/2/479.short
  2. https://www.hindawi.com/journals/mi/2013/509502/abs/
  3. http://www.jbc.org/content/280/6/4617.short
  4. https://www.jci.org/articles/view/19451
  5. https://www.ncbi.nlm.nih.gov/pubmed/17391554

Oftentimes I will have patients with diabetes whose blood sugars are high, and they think, logically, that if they eat very few (or no) carbohydrates, that will help. Unfortunately, they are working against themselves, and here’s why:

The body has what I like to refer to as a savings account of glucose in the liver. When the cells in the body aren’t getting the glucose they need for energy (like when someone skips a meal or when their cells are resistant to insulin), they start complaining all over the body trying to get someone to fix their problem. Word gets to the liver that the cells are starving and he wants to help. The trouble is, liver is a busy guy. He’s got many, many jobs. I often joke that managing this savings account is his “side gig.” He’s not particularly good at it.

In people with diabetes, liver sometimes starts dumping glucose from his savings account into the blood when he doesn’t really need to, and also he doesn’t know when to stop. He just keeps pouring and pouring sugar into the blood and before you know it, this poor person who is trying their darnedest to avoid eating carbs in order to get their blood sugars down has a sky-high blood sugar because they haven’t eaten!

It’s the most frustrating thing in the world because it’s totally backwards to what we would naturally think.

Moral of the story: don’t skip meals, and don’t over-restrict carbohydrates! It’s just as important to eat enough as it is to not eat too much to manage blood sugars in diabetes (side note: that’s true for weight loss as well!).

Bonus sub-moral of the story: If you have something frustrating going on with your blood sugars or your weight that you can’t explain, seek out a Registered Dietitian or a Certified Diabetes Educator to help explain all the funky things that your body might be doing without your realizing it! You don’t have to be frustrated and helpless. You can be empowered to better understand your body!


For me, snacks are key to carb counting survival. In general, I feel satisfied after eating a carb-controlled meal but I’m finding myself hungry 2-3 hours after the meal. Snack time!

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Ideally, a carb-controlled snack for my plan would have 15-20 grams carbohydrate and some protein (even better if it adds in fiber too!). The carbohydrates keep my energy up while protein helps keep the carbohydrates from raising blood sugar too quickly. My struggle is I’m finding the protein portion tough for some reason. Some of my favorite example snacks include:

  • 6-8 whole grain crackers with cheese
  • ¼ cup unsalted nuts with 2 Tablespoons dried fruit
  • 1 small apple with 2 Tbsp peanut or almond butter
  • 3 cups popcorn with a drizzle of olive oil, dash of salt, and garlic powder, rosemary, and thyme (it’s delicious – and even though this one doesn’t have much protein, it’s a whole grain, it’s high in fiber, and the portion is no joke)

My challenge is that often snack time ends up being on my breaks at work, and proteins are either tough to pack or they need preparation and/or refrigeration. I did a stint with mozzarella cheese sticks and they worked out really well but I got a little bored with them. I haven’t been able to make it to Winco to get the bulk mixed nuts at a decent price (I refuse to pay the prices at most grocery stores), and I’ll be honest, I’ve been too lazy to get a little container to put peanut or almond butter in. I could hard boil a bunch of eggs to have ready and take with me, but here again – too lazy, too busy. Gah.

Many times this last week, my snack has ended up being 15-20 grams carb only, without the protein. That’s less than ideal because besides regulating blood sugar, protein helps a snack be more satisfying for longer.

As I gradually add in diabetes recommendations to follow, I have to say that there is a LOT to it. I hear that from my patients all the time, and they aren’t kidding. Remembering to pack a lunch is pretty much habit, but the snacks are often a last-minute afterthought and making sure there’s protein with them seems like a nice idea that only happens when the planets align just right.

Anyway, this is all good experience for me as an RD and it backs up what I hope I communicate to my patients: do the best you can, take one step at a time, and be prepared that life is going to push you back. Life happens. Life gets crazy. Motivation comes and goes. Just be steady and do your best. After all, your life is worth fighting for!


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)!

img_0763

 

 

 

 

 

 

 

 

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:

screenshot-21

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!