Carbohydrate counting and diabetes: Looking beyond carbs

I was taught to control my blood sugar by eating a certain amount of carbohydrates at every meal. However, what about those foods that have no carbs? I say that I can eat as much of these as I want. My wife says I'm wrong.

- Jerry / New Hampshire

Mayo Clinic endocrinologist Maria Collazo-Clavell, M.D., and colleagues answer select questions from readers.

Answer

Your wife is right. Carbohydrate counting is a method of controlling the amount of carbohydrates you eat at meals and snacks. This is because they have the greatest impact on your blood sugar. But carbohydrates aren't the only dietary consideration when you have diabetes.

If you have diabetes, you are at increased risk of heart disease, kidney disease, nerve damage (diabetic neuropathy) and stroke. So it's important to limit fat and cholesterol in your diet. Counting calories also is important because controlling your weight helps control your diabetes and reduces your risk of its complications. So, just because a food contains no carbohydrates doesn't mean that you can eat it in unlimited amounts.

Your best bet is to adopt a healthy diet high in fruits, vegetables and whole grains — and low in fat and calories. If you have diabetes, you should follow these guidelines when making food choices:

Carbohydrates. Between 45 percent and 65 percent of your daily calories should come from carbohydrates.
Fat. No more than 20 percent to 35 percent of your total daily calories should come from fat. Of those calories, no more than 7 percent should come from saturated fat, and you should try to avoid all trans fat.
Protein. Between 15 percent and 20 percent of your total daily calories should come from protein.
Cholesterol. Limit cholesterol to less than 200 milligrams a day.

What's on the menu?	Carbohydrates	Cholesterol	Fat	Calories
Looking beyond carbs Although both of the following breakfasts provide the same amount of carbohydrates, breakfast No. 1 is considerably higher in calories, fat and cholesterol. Which would you choose?
Breakfast No. 1: 2 fried eggs 3 sausage links 1 cup hash browns 2 slices white toast 2 teaspoons butter 1/2 cup orange juice 1 cup regular coffee	75 grams	475 milligrams	60 grams	830
Breakfast No. 2: 3/4 cup cornflakes 1/2 banana 1 cup low-fat milk 1 slice wheat toast 1 teaspoon margarine 1/2 cup orange juice 1 cup regular coffee	75 grams	4 milligrams	5 grams	370

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