Carbohydrate Counting
To use carbohydrate counting, you must know your total carbohydrate allotment for the day. Together you and your dietitian will make a carbohydrate counting meal plan based on your usual food intake, lifestyle, diabetes medications, and physical activity. Once you have your carbohydrate counting meal plan, you'll need to become familiar with the carbohydrate content in foods.
Fat Gram Counting
Fat gram counting may be particularly useful for people with type 2 diabetes who are overweight. Fat provides two and a half times as many calories per gram as carbohydrate or protein.
The first step in using fat gram counting is to establish a daily calorie requirement based on your height, weight, activity level, and weight goal. Then, based on your nutrition goals, a daily fat gram goal will be determined. In fat gram counting, you keep a record of the foods you eat and their fat content.
Food Exchange System
Groups foods with similar nutritional value into lists with goal of helping people with diabetes eat consistent amounts of nutrients. Each food has approximately the same number of calories, carbohydrate, protein, and fat as the other foods on the same list. Any food on a list can be exchanged for food on the same list.
To use the exchange system, you need an individualized meal plan that tells you how many exchanges from each list to select for meals and snacks.
Calorie Counting
This approach is most appropriate for people who are overweight and do not take insulin.
To use calorie counting, you and your dietitian establish a calorie goal that will help you achieve your weight goal. You keep records of the foods you eat and their calorie content. A periodic comparison of your food records and weekly weight can give you feedback on how you are progressing toward your weight goal. These records can also help you identify problem areas.
| Approach |
Advantage |
Disadvantage |
| Carbohydrate Counting |
With the focus on carbohydrate, food and insulin can be matched more precisely. Also, insulin can be matched to carbohydrate eaten at specific times during the day. Thus, carbohydrate counting may be most appropriate for people with type 1 diabetes who take insulin. |
When you focus only on carbohydrate, it is easy to lose sight of the overall nutritional quality of foods. |
| Fat Gram Counting |
It is simple and it allows a considerable amount of flexibility and control over your food choices. With fat gram counting, you will usually improve the overall quality of your food choices, because you will tend to select lower fat foods, such as fruits, vegetables, grains and low-fat dairy products. |
It does not take into consideration foods that may affect your blood glucose. Therefore, your blood glucose values may be inconsistent. |
| Food Exchange System |
Gives emphasis on more than one nutrient and the importance of the overall nutritional content of foods. Also encourages consistency in the timing and amount of your meals and snacks. People desiring to lose weight might find this approach useful. |
The level of understanding needed to grasp the concept of “exchanging” foods. It also requires learning where a food that is not listed fits. |
| Calorie Counting |
Has an expanded choice of foods, which gives you more flexibility in what you eat. |
Time in keeping records and calculating the calorie content of foods. Also, making nutritionally balanced choices. |
