carb serves Archives - Diabetes Counselling Online

Making Rice Nice for Diabetes

January 12, 2015 by Sally Leave a Comment

Rice is one of those grains that can be problematic for people with diabetes, so I thought it might help if we explain a little of why that is, why different rices have varying effects on our BGLs and ways to make rice more diabetes friendly.

You may know that, generally speaking, a quarter of a cup of cooked rice is one carb serve. You can see that in this snip from CalorieKing showing that half a cup of boiled rice = 28.8g carb (or 2 carb serves).

And this photo shows you what half a cup of cooked rice (2 carb serves) looks like on a plate.

You may also know that, particularly for us with diabetes, we’re better having rice that breaks down more slowly to glucose in our bloodstream, or low-GI rice. The main types in Australia of low GI rices are long grain rices including Basmati and Doongara. Even when choosing brown rice for the extra fibre, we’re best to choose brown Basmati or Doongara.

This mini-table gives you a feel for the glycemic indexes of various rice products.

Source: Low GI Diet Shoppers Guide 2014

Rice type	Glycemic Index	Glycemic Index rating
Aborio/risotto rice, boiled, SunRice	69	Medium
Basmati white rice, boiled, SunRice	59	Medium
Basmati white rice, SunRice, microwave pouch	52	Low
Calrose rice, brown, medium-grain, boiled	76	High
Calrose rice, white, medium-grain, boiled	87	High
Japanese style sushi rice, SunRice	89	High
Jasmine fragrant rice, SunRice	73	High
Long-grain rice, white, boiled 15 mins, Mahatma	50	Low
Low-GI Long-Grain rice, Brown, SunRice	54	Low

This is only a snapshot, but it indicates that there’s quite a difference in how quickly the different rice types break down to glucose in our bloodstream. It’s also worth bearing in mind that the longer you cook any rice the higher it’s GI rating will become, so try to keep it tender, not mushy.

What makes these rices different in GI is the type of starches they contain combined with the shape of the grains. The two main starches found in rice varieties are amylose and amylopectin. Wikipedia explains that high-amylose varieties of rice, the less sticky long-grain rice, have a much lower glycemic load. It’s to do with the chemical structure of the starches.

Nutritionally rice is mostly starch (80-90%). This snip from Wikipedia shows the nutritional content of Rice, white, long-grain, raw, and demonstrates that it doesn’t add a whole lot of nutrients to our meals other than carbohydrate.

By keeping your portion sizes reasonable, consuming protein foods and vegetables with your rice meal will add nutrients and lower the overall GI of the meal.

And dishes that you’ve previously always used rice in can be nutritionally enhanced by swapping in other forms of more nutritious grains such as barley, quinoa and cracked wheat. Why not do an experiment and try some swaps out for yourself? One of my dietitian colleagues makes her sushi with quinoa, and barley risotto is amazing! Here’s a recipe from Taste.com.au for it.

One trick with rice is to combine it with other grains for added fibre and nutrients and to further lower the glycemic index and improve that nutritional profile.

Fortunately more and more options are available to us.

The Australian company, SunRice, has a great range of ‘Health & Wellbeing’ rices and rice blends that you may like to consider trying.

And Coles also has recently launched some similar products that are all high in fibre and have a low glycemic index too. The varieties available are:

Brown Rice and Quinoa
Brown Rice and Chia seeds
7 Ancient Grains – a combination of brown rice, green lentils, millet, quinoa, sorghum, amaranth and chia seeds (the highest fibre variety).

These microwaveable packs usually contain 2 serves per pack. You should check the Total Carb per Serve column to check how many carb serves a ‘serve’ contains. It’s usually about two. They’re very convenient quality carb options to keep in your pantry.

Resistant starch

Just a reminder while we’re on the subject of starches, that cooked and cooled starches develop a crystalline structure which makes them resistant to digestion (hence their name) which lowers their glycemic index. So adding cooked and cooled rice to your salads is a great way of adding a serve or two of low-GI carbs to your meal to help manage your blood glucose levels and provide the many benefits associated with including low-GI carbs in each meal. The theory of resistant starch goes that if the starch resists digestion it will end up in the large bowel to feed the good bacteria which in turn improve our immunity and overall wellbeing. You can read more in the blog on fibre if you’re interested.

So I hope you learned how to make rice work better for you. Please let us know if you have any questions. Sally

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a linked list of all Sally’s Diabetes Counselling Online blogs here.

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Discussion on low carb diets

July 28, 2014 by Sally 8 Comments

Australian Guide to healthy eating poster

By popular demand through a thread in our Facebook group Diabetes and Food – let’s celebrate it!, this topic deserves a blog to help explain some of the ‘stuff we hear’ around carbohydrates and type 2 diabetes. I’d also encourage people with type 1 diabetes to read this though, because some of the points made are also relevant for us! Up front I will remind you that everyone has individual requirements and should see an Accredited Practising Dietitian for a personalised consultation, so this is a ‘general guide’ only.

Firstly we need to understand what ‘low’ means in such a context as in my experience as an Accredited Practising Dietitian, people tend to associate ‘low’ with ‘virtually no’ carbohydrate. We’ll also look at some of the evidence that shows that ‘low’ carb diets can help with glucose control in type 2s, and why when drugs (other than metformin or SGLT2-inhibitors) are introduced it’s important to ensure more (quality) carb intakes as advised by your health professionals. And lastly (but certainly not leastly) we’ll review how, based on the Australian Dietary Guidelines, it’s possible to have a nutritionally balanced diet while watching your carb intake.

What does ‘low’ carbohydrate mean?

If you ask some people what they think ‘low carb’ means, you may hear that it’s about cutting carbohydrates out as much as possible. Straight up as a dietitian my alarm bells ring as carbs feature in all five of the food groups that we need for nutrients to ensure our wellbeing: vegetables (starchy vegetables like potato, sweet potato and corn), fruit, dairy, protein (when the likes of legumes are included, and especially in vegetarian diets) and of course, the important grain/cereal foods.

The American Diabetes Association defines a low-carb diet as 130g of carb per day. Does that surprise you?? The ‘trick’ with low carb diets is therefore to know how to choose your carbs wisely so that you’re still meeting your nutrient requirements, and also to know what to replace that carb energy with (remembering that carbs, proteins and fats make up our daily energy intake) so you don’t get too hungry and be encouraged to ‘cheat’.

Remembering that there’s 15g of carbohydrate in an ‘exchange’ or ‘serve’ that gives us close to 9 carb serves across the day.

If you’re on medication that helps your body to produce more insulin, or you’re providing insulin yourself on a fixed dose then this idea is dangerous to your health so please speak to your health professionals before making any changes to your diet.

Some benefits of lower carbohydrate diets

Of course we know that all carbohydrates break down to glucose which is the fuel needed by our bodies, but in modern diets often too much (and poor quality) of this ‘fuel’ is provided which can cause stress to our organs and worsen our diabetes control. So understanding the benefits of a lower carbohydrate diet can help us to stick with it for longer and balance the rest of our diets more easily.

Some of those benefits may include:

Lower incidence of high blood glucose levels (hyperglycemia)
Lower amounts of medications need to control hyperglycemia
130g/day is a sustainable amount, meaning it’s easier to stick to in the longer term
Putting your pancreas under less stress to produce insulin, thereby helping it to keep working for longer
By ensuring your 130g/day is nutritious and low-GI carb you may also improve your blood fat levels (cholesterol/triglycerides) which will lower your risk of cardiovascular disease
It doesn’t necessarily lead to weight loss – that depends on your total energy intake.

How do you manage it best?

Again I will mention how important having a personalised consultation with your Accredited Practising Dietitian is because everyone is different in many ways. Here I will make suggestions that I hope will help to get your head around combining the idea of low carb into your daily routine while still meeting the nutritional requirements as outlined in the Australian Dietary Guidelines foundation diet (see page 2).

In a nutshell, it’s about only choosing your carb sources from the 5 food groups and balancing that out with quality proteins and healthy fats. I encourage you to re-read the previous blogs I’ve written on those topics as highlighted.

Remembering that 130g/day equates to close to 9 carb exchanges/serves, your day might start to look a bit like this:

Breakfast: ¼ cup of raw rolled oats (1 serve carb) served with 125ml light milk (half a serve), a small banana (85g – 1 carb serve) and a tablespoon of LSA mix (for extra fibre/protein) = 2.5 serves total

Morning Tea: A 100g tub of low-fat yogurt = 1 serve total

Lunch: A sandwich made on wholegrain bread (the grainer the better – 2 serves) made with a protein serve and as much non-starchy veg as you can handle, either on the sandwich or as a side, using half an avocado as the spread (for your good fats), and a piece of fruit such as an apple or pear (both good low-GI fruits – 1 serve) = 3 serves total

Afternoon Tea: A 30g handful of mixed unsalted nuts = not worth counting carb-wise

Dinner: Remembering the balanced plate being one quarter carb, one quarter protein and half non-starchy vegetables, this works with so many meals. Aim for your carb serve to = 2 serves total

Supper: You’ve still got half a carb serve up your sleeve. I would encourage something like half a slice of grainy toast with peanut butter on it to give you the energy to get you through the night, but half a serve of low-fat dairy would also work well, or even a couple of squares of dark chocolate if you fancied it = 0.5 serves total

In this example you can see that we’ve incorporated 9 carb serves/exchanges and yet have included quality carbs at every meal.

Some final tips

Remember to include protein and some non-starchy veg with every meal.
Rice and pasta can be problematic a serve size is so small. Something I recommend that works for many people is to include the carb serves in the form of legumes (lentils, chickpeas, kidney beans, etc) in the pasta sauce and use low-carb alternatives such as those made from konjac root, or make pasta/rice out of vegetables such as grated zucchini or carrot or cauliflower. I sometimes serve my pasta sauces on mashed cannellini beans and frozen spinach (warmed of course!) and find it’s very satisfying.
Don’t forget to exercise! If the point of minimising your carbs is to control your BGLs, then even as little as ten minutes exercise after meals can make a fantastic difference to your readings. Do some self-experimenting about how much your BGLs drop after say 10, 20 or 30 minutes walking after meals, and then if you want to include more quality carbohydrates in some meals, you’ll know how to manage better.

I hope this has proved useful for you, and that you have a better understanding of how a low-carb (130g/day) might help with your diabetes control. Of course please ask any questions below and I’ll be happy to address them for you.

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a list of all Sally’s Diabetes Counselling Online blogs here.

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Dairy & Diabetes Part 2 – milk comparisons and more ideas

February 10, 2014 by Sally Leave a Comment

Hoping that after last week’s blog on dairy foods, you found some inspiration to meet your dietary targets for dairy and alternatives, especially knowing how good it is for glycemic control. This past week has also brought more evidence to light about the health benefits of consuming dairy, all the more reason to make it a focus in your own eating regime.

As promised, this week we’ll take a closer look at the nutritional differences between dairy and its alternatives and a few practical examples of how to incorporate more into your diet if you’re not meeting the guidelines.

So starting with the nutritional differences, I decided to make you a table based on various milks/milk alternatives. I searched CalorieKing.com.au and found what 250ml of each drink contained. Where there’s a dash (-) there was no data available.

Type of drink (250ml)	Energy (kJ)	Carb (g)	Protein (g)	Total Fat (g)	Calcium (mg)	Sodium (mg)	Fibre (g)
Lactose free, skim	360	12	8.5	0.3	305	88	–
Cow’s full fat	738	15.8	8.8	8.8	270	113	–
Cow’s skim	375	12.5	9	0.3	300	125	0
Almond, unsweetened	178	1	1.5	3.5	187.5	100	0.8
Soy milk, lite	398	7.5	7.5	3.8	300	225	1.3
Soy milk, regular	550	8	8	7.5	300	225	1.3

So when you’re considering what type of milk or milk alternative you should be having, not only does your decision depend on your intolerances but you also should think about the energy balance in your diet as well as calcium (aim for the 300mg mark per 250ml/1200mg per 100ml), sodium and even fibre!

When it comes to the carbs, remember that we encourage low-GI carbs with each meal and with snacks for many reasons (see benefits of low-GI blog for more info) including our glycemic control. So dairy carbs are good carbs for us with diabetes. Avoiding them won’t do you any favours.

Taking a further look at energy, you can see that those containing higher levels of fat are much higher in energy so if you’re watching your weight it makes sense to choose the lower fat varieties. The cow’s full fat has twice as much energy/kilojoules as the skim version, and a little less calcium.

For calcium, most of us as adults need between 1000mg and 1300mg per day, as outlined on page 154 of the National Health and Medical Research Council document of Nutrient Reference Values for Australia and New Zealand.

It’s also clear that the soy milks stand up well against the cow’s milk options, but have a third less carbohydrate and close to double the sodium in comparison.

(If you click on the image, it will show you an enlarged version).

In terms of meeting those 2.5-4 serves of dairy each day as outlined in the Australian Dietary Guidelines for Adults, breakfast is excellent place to start. As we also have diabetes to consider, we need to think through how many carb serves we’re having when we have a serve of dairy meaning sometimes a full serve will need to be halved. I’ve tried to explain this in more details with the examples provided.

If you’re making a smoothie with frozen berries, ¼ cup of raw oats and 500ml skim milk, that gives you two dairy serves first up, and three good quality carb serves to get you up and running in the morning as well as many other nutritional benefits.

Making a milk based coffee is also a good start. 250ml milk with strong coffee added will make you feel like you’re in a cafe having a latte and gives you a carb serve. Have that with your low-GI breakfast cereal served with milk and you’re already 1.5 serves on your way.

Not that I’m encouraging coffee, but if you’re out and about a milk-based drink such as a latte is good option for morning or afternoon tea – just don’t be tempted by other goodies in the place you buy it Of course, just a glass of cold milk is a perfect option too!

A tub of yogurt also makes an awesome low-GI snack, whether its morning tea, afternoon tea or dessert/supper. A quick look at CalorieKing.com.au tells me that a 100g tub of a low-fat fruit flavoured yogurt is about one carb serve (about 15g carb) and equates to half a serve of dairy. There’s no harm in having two of these across your day either if you enjoy them.

When it comes to cheese we should be careful from a heart health point of view, but if you can aim to choose a low-sodium and low-fat variety, a couple of slices will provide you with the equivalent of a serve of dairy – great for a sandwich. And of course, there’s no need to think about carbs with this one! You could use the equivalent of grated in your main meal or through a salad to add some oompff to your veggies.

And to finish off your day with a good low-GI pre-bed snack dairy is the perfect option. A warm glass of milk should help to get you nodding off and help to keep your blood sugars stable through the night.

Watch out for icecream though as although it’s a dairy source there’s only 100mg of calcium (1/3 of a serve) in half a cup of icecream (about 2 carb serves).

How do You ensure an adequate dairy intake?

Sally

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), has had type 1 diabetes for close to 40 years and coeliac disease for many years too.

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