Updated June 22, 2006

Are You Label-Able?

by Belinda O’Connell, M.S., R.D., C.D.E., and Laura Hieronymus, M.S.Ed., A.P.R.N., B.C.-A.D.M., C.D.E.

Listed under “Total Carbohydrate” are the amounts of the different types of carbohydrate present in the food. These may include Dietary Fiber, Sugars, Sugar Alcohols, and Other Carbohydrates.

Many people are concerned about the amount of sugar they are getting. The amount of “Sugars” on a food label can give you important clues about how generally healthy a food is: Foods that contain a great deal of sugar are generally not good sources of fiber, vitamins, or minerals and may be high in total fat or saturated fat as well. Nonetheless, the number of grams of “Sugars” listed on the food label is not the most important factor to consider when evaluating how a food will affect your blood glucose level. “Total Carbohydrate” will give you a more accurate picture of how a serving of a particular food will affect your blood glucose level.

The “Dietary Fiber” listing on food labels can be used to identify healthier entrées, breads, grains, cereals, sweets, and snack foods. The percent Daily Value for fiber is 25 grams for a 2,000-calorie diet, but most Americans do not get that much fiber on a daily basis. To increase your fiber intake, try to choose breads, grains, and snack foods that provide at least 3 grams of fiber per serving and cereals and entrées that provide 5 or more grams of fiber per serving.

If you are eating a food with more than 5 grams per serving, you can subtract the grams of “Dietary Fiber” from the grams of “Total Carbohydrate” before you calculate the number of carbohydrate choices in your meal. This is done because dietary fiber is not digested and does not increase blood glucose levels.

Many sweets marketed to people with diabetes contain sugar alcohols, such as xylitol, mannitol, and sorbitol. Sugar alcohols have a lower caloric value and raise blood glucose levels less than other forms of carbohydrate, but foods made with sugar alcohols are not necessarily “healthier” or even lower in carbohydrate than foods sweetened with sugar. To determine how a food fits into your meal plan, look at the number of calories and amounts of “Total Carbohydrate,” “Total Fat,” and “Saturated Fat” the food contains. If the food has fewer calories and less carbohydrate and fat than other, similar products, it is probably a better choice, but in many cases, the amounts of “Total Carbohydrate,” “Total Fat,” or other nutrients are not significantly different for foods containing sugar alcohols than for other, similar foods. For example, if you compare the nutrition information for Murray Sugar-Free Fudge Dipped Shortbread Cookies made with sugar alcohols and a grocery store brand of Regular Fudge Dipped Shortbread Cookies made with sugar, you can see the sugar-free version is not necessarily a better choice.

MURRAY SUGAR-FREE FUDGE DIPPED SHORTBREAD COOKIES
(Made with sorbitol)
Serving Size: 5 cookies (29 g)
Calories: 130
Total Fat: 7 g
Total Carbohydrate: 20 g
Sugars: 0 g
Sugar Alcohol: 9 g
Number of Carbohydrate Choices: 1

REGULAR FUDGE DIPPED SHORTBREAD COOKIES
(Made with sugar)
Serving Size: 2 cookies (25 g)
Calories: 120
Total Fat: 6 g
Total Carbohydrate: 17 g
Sugars: 8 g
Sugar Alcohol: 0 g
Number of Carbohydrate Choices: 1

Since sugar alcohols have a lower caloric value (2–3 calories per gram versus 4 calories per gram for other carbohydrates) and cause a somewhat lower blood glucose response, they are counted somewhat differently from other carbohydrates. If a food contains 5 grams of sugar alcohols or more per serving, you can subtract half the grams of “Sugar Alcohols” from the “Total Carbohydrate” value before calculating the carbohydrate choices in your meal or snack.

Protein. The amount of protein you need is based on your size, calorie needs, and stage of life. The ADA recommends that adults with diabetes get about 10% to 20% of their daily calorie requirement from protein. Most labels do not list a percent Daily Value for protein because most Americans get adequate amounts of protein and it is not considered a nutritional concern, so it does not need to be highlighted on the food label. In general, men need about 60 grams of protein per day, and women need about 45–50 grams of protein per day.

Belinda O’Connell is a Diabetes Nutrition Specialist at the International Diabetes Center in Minneapolis, Minnesota, and a freelance health and science writer. Laura Hieronymus is the program coordinator/nurse educator for Drs. Borders and Associates, PSC, an American Diabetes Association–recognized education service in Lexington, Kentucky.

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