Everything You Need to Know About Diabetes and Portion Control

The growth in diabetes diagnoses seems to have kept pace with the expansion of our portions—and our waist lines. Might there be a connection? Certainly larger portions mean extra calories and carbohydrates, which leads to weight gain. Extra weight is a precursor to type 2 diabetes, and two of the primary treatments of type 2 diabetes is weight loss and carbohydrate control. And carbohydrate control can only be accomplished with portion management.

How Do You Measure Up?

With diabetes, you need to develop a skill for guestimating portions. Try this checklist to see if you are measuring up:

- Do you own measuring cups?

- Do you have measuring spoons?

- Do you own a food scale?

- Have you measured the amount of liquid your favorite drinking glass , juice glass, and coffee cup hold?

- How much cereal does your cereal bowl hold?

- How big is the plate you use for dinner?

- Have you measured 1 cup of cooked pasta and put it on your plate?

- Is your tortilla 6 inches across?

- About how many green beans in ½ cup?

- How many blueberries in ¾ cup?

- How many almonds in one ounce?

- Have you measured the amount of salad dressing you use on your salad?

- How many ounces is the protein portion on your plate?

- How many ounces of protein do you put in a sandwich?

- How much fiber is in a slice of the bread you buy?

- How many level tablespoons of peanut butter do you put on your bread?

Do you feel like you are in a food lab? Your kitchen is your preparation for success with diabetes in the outside world. Some people with diabetes have been comfortable with cooking for years, so these questions are not too challenging. However, if you have never measured your cereal, or salad dressing, spend some time getting familiar with common portions. You can not accurately control carbohydrates, and calories, without a basic working knowledge of portions.

Portion Control Guide

Most dieters learn to estimate portions with this easy guide:

Thumb tip 1 tsp 1 measure of oil, butter, mayonnaise

Thumb 1 tbsp 1 measure of salad dressing, peanut butter

4 dice 1 oz. Cheese

½ baseball ½ cup Cooked vegetable, potato, cooked cereal

Baseball 1 cup Apple, orange, 3 servings rice

Deck of Cards 3 oz. Cooked meat, chicken, fish, luncheon meat

Portions to Carbs

So, now you can give an educated guess as to the amount of spaghetti in the restaurant portion on your plate. (Actually, even the best of us have trouble with a mound of pasta on an oversized restaurant plate!) So, how many carbohydrates in that plate of pasta? If you are on insulin, how much medicine do you need to cover that food? Are there any other carbohydrates lurking in that meal? (Bread, croutons, drinks, deserts?) Do you see why you need to pay attention?

Good Old Exchange List

Yes, it comes back to that lesson on the Diabetic Exchange Lists that you promptly forgot. Let’s make it simple, and therefore workable.

The three main food groups that contain mostly carbohydrates are starches, fruit and milk. Each serving, as defined on “the lists” is about 15 grams of carbohydrate. If you eat 2 servings, you have 30 grams of carbohydrates, 3 servings, 45 grams, etc.

All you have to memorize is the serving size on “the list," not on the box label.

Here is a simplified start - Servings that equal 15 grams of carbs ( or one carb choice):

Food Group	One serving
Milk Group	8 oz. milk
(90 calories, no-fat)	1 cup plain yogurt
Fruit	1 whole medium fresh fruit
(60 calories, no added sugar)	1/2 banana
	½ cup no sugar added canned fruit
	1 cup berries, melons
	2 Tbsp dried fruit
Starch	1 slice bread
(80 calories, no added fat or sugar)	¾ c dried cereal
	½ cup cooked cereal
	4-6 crackers
	1/3 cup pasta or rice
	½ cup potato, corn, beans , peas
	3 cups popcorn
	1 oz pretzels

Your meal plan, as developed for you by your dietitian, will define how many servings of milk, fruit and starch you should have at each meal and snack, and the total for the day. This can be different for each person with diabetes, but generally, we recommend 45-60 grams carbs per meal, and 15-30 grams carbs per snack.

Take a Guess!

Here is a cup of white rice, no added fat. It has about 220 calories. How many grams of carbohydrate?

45 grams! If 1/3 cup has 15 grams, 3 times that is 45 grams.

In comparison, the low calorie vegetables not listed in the starch group, such as broccoli, zucchini, green beans, tomatoes, have about 5 grams of carbohydrate for ½ cup cooked or 1 cup raw. We recommend lots of vegetables on your plate, to take up space on your plate and in your tummy, in addition to all the health benefits. And, you do not get a concentrated source of carbohydrates.

Here is 10 cups of cooked cauliflower, 220 calories—guess how many carbohydrates?

About 45 grams! Same as that little cup of rice.

To learn more about portion control try:

Portion Distortion Interactive Quiz

Downloadable Serving Size Card

10 Portion Control Tips For People with Diabetes:
1. Keep a set of measuring cups on your counter to quickly measure your starches such as rice, potato, cereal , corn, etc. Starches are dense in carbohydrates, so it is easy to underestimate the amount you are about to eat.
2. Measure the 8 oz. mark on your glasses and cups, and take note. Also measure 4 oz on the glass you drink juice from.
3. Use a tablespoon to put salad dressing on your individual salad, peanut butter on your sandwich, and mayo (3 fat servings!) in your tuna. Although these fats do not add carbohydrate to your intake, they do add twice the calories!
4. Consider getting a food scale, to weigh your protein. Or, for a while, purchase your meat, chicken and fish in pre-portioned servings or you can learn what 3, 4, or 5 oz looks like. Protein will not add carbohydrates to your intake, but calories do count.
5. Use the plate method—fill half your plate with low carb vegetables, so there is less room to oversize your starch and meat.
6. Use a smaller plate for your dinner—or even buy plates with portioned sections to guide you.
7. When you buy snacks, measure out 15 grams worth of crackers in a snack size plastic bag (do the whole box) and but them all back in. When you grab a snack, you know how many carbs you are getting. You can purchase 100 calorie snack foods ( about 15-20 gram carbs) already measured and packaged.
8. Consider buying your ice cream confection in Dixie cups or popsicles so you have a measured portion rather than hearty scoops from the carton into a dish.
9. Keep serving dishes off the table. It is too easy to scoop more food on your plate. More salad or low cal vegetables could sit on the table.
10.If all else fails, only have 1 cup, a baseball size, of the starch on your plate. Leave the rest, or even over-pepper it so you do not nibble it. A cup of starch is about 45 grams of carbs at the most, so this will suffice.

What is the difference between a portion and a serving?

A “portion” is how much food you choose to eat at one time, whether on your plate, in a restaurant or from a package. A “serving” size is a defined amount of food with nutrition information, such as a serving size on a Nutrition Fact Label. Take note, the servings sizes of food on the food label are not the same as the servings sizes defining carbohydrates in the exchange lists.

You can still use this information to watch your carbohydrate intake. So, if you decide to eat Cheerios, you can see from the label below that if you have 1 cup, you will eat 22 grams of carbohydrates (and 120 calories). Oh yes, if you add 1/2cup of skim milk, add 6 more grams of carbs. The trick is to measure and know how much you have—and eat that much!