• Food is made up of macronutrients: carbohydrate, protein, and fat.
  • Carbohydrates have the greatest effect on blood glucose with 100% of absorbable carbohydrate becoming glucose in the blood.
  • Protein and fat do not have a significant effect on blood glucose but they may help to slow the rise in blood glucose and help to keep blood glucose more stable.
• Carbohydrates include: sugar, starch, and fiber.
  • Sugars: includes natural sugar in fruit and milk and added sugars, like in soda, juice and other beverages and packaged food.
  • Starches:
    • Wheats, oats, and other grains (e.g. bread, pasta, rice, cereals)
    • Starchy vegetables such as corn and potatoes
    • Dried beans, lentils, and peas
    • Non-starchy vegetables contain small amounts of carbohydrates.
  • Fiber: the part of plant food that isn't digested but helps you stay healthy. Fiber cannot be converted to glucose so it does not raise blood glucose.
  • Foods that include ingredients from these groups should be counted toward carbohydrate totals. Examples: casseroles, soups, pizza, snacks (chips, French fries) and sweets.

How to read a food label to count carbohydrates:

1. Check the Serving Size first. All nutrient totals are listed according to the serving size listed. Yo umay see a number of grams listed next to serving size (e.g. 114g on sample label). This is weight of the serving size and should not be used in the total carbohydrate calculation.
2. Portion size = how much your child plans to eat. Compare portion size to serving size.
3. Check Total Carbohydrate. Total carbohydrate includes all three types: sugar, starch, fiber so you do not need to add these separately.
   1. Please note "net carbs" may be listed on food packaging but should not be used for carbohydrate calculation.
   2. Also, "sugar free" and "no sugar added" do not necessarily mean carbohydrate free, so you should still review and count total carbohydrate for these foods and drinks.
4. Calculate how much carbohydrate is in the portion your child plans to eat.
   Example (see sample label to the side):
   Serving size = 1/2 Cup (114g)
   Portion size = 1 Cup (228g)
   Total carbohydrate per 1/2 Cup serving size = 13g 
   Total carbohydrate per 1 Cup portion size = 13g x 2 = 26g 

If a label is not available:

• Search the internet for carbohydrate totals for specific foods.
• Use smartphone apps (e.g. Calorie King, My Net Diary, My Fitness Pal).
• If you are cooking, you can determine carbohydrate counts for each ingredient in a recipe by searching the internet or smartphone app or try to find similar recipes that contain those ingredients.

Benefits of a balanced diet:

• Fiber, protein, and fat can help slow down how quickly food is broken down, leading to a slower rise in blood glucose. This can also help prevent fast drops in blood glucose.
• Fiber, protein, and fat can help improve satiety. If your child often complains of hunger, adding foods with fiber, protein, and/or fat, may help to satisfy them in a smaller portion and/or decrease desire for frequent snacks.
• A balanced plate is often recommended as a healthy diet that may help to reduce insulin resistance with type-2 diabetes.
• Individuals with diabetes may be at higher risk of long-term cardiovascular complications. A balanced diet that includes adequate intake of fiber, healthy fats, and lean proteins may help to prevent or reduce complications.
• For more information on the balanced plate, visit myplate.gov. You can also request a referral to see one of our registered dietitians for nutrition counseling.