Читать книгу Practical Carbohydrate Counting - Hope S. Warshaw - Страница 17

People need to have a sense of how much food represents one, two, or three or more servings of a food that contains carbohydrate. They need to be able to translate the amount of carbohydrate (in either grams or servings) they should eat into real amounts of food. In the language of diabetes exchanges/choices, one serving of a starch, fruit, or milk serving equals about 15 grams of carbohydrate and one serving of nonstarchy vegetables equals about 5 grams of carbohydrate (Pastors, Arnold, et al. 2003). Table 3-3 provides a chart with the average macronutrients per serving in major food groups (Pastors, Arnold, et al. 2003).

The average amounts of carbohydrate in Table 3-3 can be used to teach generalities about the grams of carbohydrate per food group without mentioning the word “exchanges” or “choices.” Recognize that as the exchange/choice system is used less frequently to educate people with diabetes (particularly as more educators use carbohydrate counting), fewer people will be familiar with the exchange/choice system. Also recognize that there are different definitions of “servings.” Consider the definitions used herein as well as the definitions on the Nutrition Facts panels of foods set by the U.S. FDA. Table 3-4 provides examples of how these can be similar or different.

Even as counting grams of carbohydrate grows in popularity, many educators prefer to teach servings of carbohydrate. There is rationale for teaching one or the other or both. Some educators believe that if someone is familiar with the exchange/choice system and/or the fact that 15 grams of carbohydrate is a serving or one carbohydrate choice, then this knowledge should be used. The downside of only teaching servings (or choices) is that people have no base for translating the Nutrition Facts of food labels or other resources that only provide grams of carbohydrate.

Another downside of teaching exchanges/choices is that it introduces yet another term to a person’s carbohydrate counting lexicon. Some educators believe that teaching people to count grams of carbohydrate is more precise and makes it easier to use the variety of carbohydrate counting resources available. For people learning and using Basic Carbohydrate Counting, providing both a count of carbohydrate grams as well as servings (total and per meal) may be most helpful, as shown in Table 3-2. People who progress to using Advanced Carbohydrate Counting should be trained use the more precise practice of counting grams of carbohydrate. Averaging based on servings will not match medication as precisely.