Fruits. Portion sizes for fruit can vary a lot. For example, 2 tablespoons of raisins, 1/3–1/2 cup of fruit juice, and 1 cup of melon each contain approximately 15 grams of carbohydrate (and about 60 calories, 0 grams of protein, and 0 grams of fat). That’s something to keep in mind when choosing a fruit exchange for your meal or snack — do you want something that will fill you up, or just a little something sweet? For some people, eating a serving of fruit at each meal can help to satisfy a sweet tooth and make it easier to say no to higher-fat sweets such as ice cream or cookies.
Milk. Dairy products such as milk and yogurt provide your body with calcium, riboflavin, and protein, as well as carbohydrate. One serving of milk or yogurt provides about 12–15 grams of carbohydrate and 8 grams of protein. Calorie and fat content depends on whether you choose whole, reduced-fat, low-fat, or nonfat products. Low-fat or nonfat dairy products are generally better choices for adults and children over two, but if you eat higher-fat products, don’t forget to count the grams of carbohydrate just the same.
More carbohydrates. It’s no secret anymore that many people with diabetes include some sugar or sugar-sweetened foods in their meal plan without having their blood glucose level zoom sky-high. Their secret? Planning ahead and learning to swap carbohydrate choices. For example, rather than eating lunch, then deciding they want some ice cream, they plan to eat a half-cup serving of ice cream as one of their carbohydrate choices or exchanges for the meal. That way, they get their ice cream but don’t surpass their total carbohydrate goal for lunch. Of course, people who adjust their premeal insulin dose according to the carbohydrate content of a meal might choose to simply add the ice cream to the meal and take more insulin. This tactic can keep blood glucose levels in target range, but it can also lead to weight gain if used too frequently.
How often you substitute sweet items for breads, starches, milk, or fruit is a matter of personal preference. For most people, it’s a good idea to do it only occasionally, since sweets generally have few nutrients other than carbohydrate and sometimes fat. For children or very active people who burn a lot of calories, however, a sweet or snack such as potato chips might be included in their meal plan on a daily basis. Older people generally have lower calorie needs and, ironically, higher vitamin and mineral needs, so eating too many sweets can rob them of needed nutrients and make it harder to maintain a desirable weight.
Another problem with sweets and desserts is that one serving (containing 15 grams of carbohydrate) is often small and not very filling, so it’s tempting to have two or three servings rather than one. You can help quell that urge by including higher-fiber foods such as beans, lentils, or cooked vegetables in the meal preceding dessert or by adding a big green salad with low-fat dressing to your meal; salad greens tend to fill you up without affecting blood glucose levels.
Carbohydrate counting is what gets emphasized most in diabetes meal planning, but foods with little carbohydrate should be counted too — for weight control and heart health as well as for blood glucose control.
Nutrition experts often classify lower-carbohydrate foods into four different categories: vegetables, meats and meat substitutes, fats, and “free foods.” When eaten in moderation, these foods do not have a direct effect on blood glucose level. However, eating too many servings of some free foods can raise blood glucose level, and eating too much meat, meat substitutes, or fat can lead to unwanted weight gain, which can also affect blood glucose control. So portion size is important even for most low-carbohydrate foods.