1. Carbohydrate Counting Linda St. Clair, MS, RD, LD, CDE Office of Child Nutrition WV Department of Education

2. I have diabetes. What should I eat? • Balance your plate • Exchange Plan • Carbohydrate counting

3. Choose MyPlate PROS • Simple to use • Visual • Balanced CONS • Uses estimates • Combination foods are difficult

4. Exchange Lists • Controls all aspects of diet • Requires a list of foods and their portion size • Combination/packaged foods are difficult

5. Carbohydrate Counting • Focuses on the main nutrient that raises blood sugar • No “good/bad” foods • Uses readily available information from food labels or lists • Most accurate of all methods

6. No Matter Which Plan is Chosen… • Keep food intake consistent from day to day • Choose whole grains half the time • Choose whole fruits and vegetables most of the time • Choose lean proteins • Choose low-fat dairy products • Limit fats, salt and sugars • Limit sugary beverages; choose water

7. Know which foods contain carbohydrate • Grains (breads, crackers, rice, hot and cold cereals, pasta, tortillas • Starchy vegetables (potatoes, peas, corn, winter squash, legumes/beans • Fruits and juices • Milk and yogurt • Sweets and desserts

8. Keys to accurately estimating carbs • Recordkeeping • Portion size • Using food labels correctly • Allowing for added carbohydrates

9. How to keep a food diary • Write down everything • Recording foods before they are eaten is best • If not, as soon as possible (not at the end of the day) • Be honest • Use the information to help make better choices the next time

10. Barriers to keeping a food diary • Takes too much time • Too difficult • Forget • Not convenient • Don’t know the carb content • Ignorance is bliss

11. Estimating Portion Sizes • Make it easy to visualize • Use measuring cups/spoons correctly • Use common items as references

12. Using food labels Serving Size Total Carbohydrates

13. Added Carbohydrates • Chicken breast, batter dipped = 13 gm carb • Chicken breast, roasted with no breading = 0 gm carb

14. Resources for Accurate Carbohydrate Counting • Food labels • Computerized nutrient analysis • Recipes • Websites/booklets

15. Nutrient Analysis

16. Free Resources

17. Great websites • Calorie King – www.calorieking.com • The USDA National Nutrient Database - http://www.nal.usda.gov/fnic/foodcomp/search • MyFoodAdvisor– http://tracker.diabetes.org/explore/ • USDA Supertracker – https://www.supertracker.usda.gov/default.as • MyFitnessPal – http://myfitnesspal.com/mobile

18. Special Dietary Needs “Accommodating Children with Special Dietary Needs in the School Nutrition Programs” USDA Guidance for School Food Service Staff

19. Diabetes Teams at School • Student with diabetes • Parents of student with diabetes • School Nurse • Cafeteria Manager • Foodservice Director • Teacher • Principal • Others?

20. Who Does What? • Every situation is different • Team approach is always best • Use every resource at your disposal REMEMBER – it’s about the student’s needs!

21. QUESTIONS! Linda St. Clair, MS, RD, LD, CDE lsstclai@access.k12.wv.us 304-558-3396