Wednesday, 1 May 2013

Maximising food choice and portion size variations

I nearly called this blog site “The Carb Counter” as when fumbling around for site names, I realised the carbohydrate counting thing was one of the major changes I had to embrace to live with diabetes.

We live busy lives and increasingly consume foods in less formal ways away from the traditional family home. These foods are often produced and made by others, and do not always have that illusive nutritional label. Subsequently counting carbohydrates or understanding the total weight of carbohydrate consumed is complex and not straight forward in today’s modern food environments.

My own carb counting nemesis is usually the business meeting lunch buffet. You know the one designed to make you fall asleep through that important afternoon session. Whoever designs the catering offering at such events is certainly not a person with pancreatic issues. The food offering is usually the bastion of odd sized and shaped sandwiches, bizarre pastry products with fancy lattice work and obscures bite size ditties, where you are never quite sure if they are plant, animal, mineral or “other”. That’s before we even get to the mini pizza squares and odd shaped single portion desserts.

The straight jacketing of a strict portion size and food type controlled diet for people with T1 diabetes of yesteryear has been replaced with the modern day carbohydrate counter. Trying to make our way in the very complex food landscape that is the 21st century retail consumer environment takes effort skills and knowledge.

In its most simplistic form we have 6 alternatives to help us maintain our freedom from the straight jackets of yesteryear. The reality is a little more complex but bare with me for the purpose of this blog.

  1. Guestimate (not recommended for longevity or short term sanity)
  2. Weigh ALL foods consumed that contain carbohydrate.
  3. Limit dietary intake to types and amounts of food where we are confident of carbohydrate load.
  4. Eat foods with clear nutritional labelling of carbohydrate load.
  5.   Estimate food portion size and deduce the carbohydrate load.
  6.  Use previous knowledge from past experience (scales, labels, photos or trial and error)

On most days I will use 4 if not 5 of the above at certain times. This usually depends on my familiarity with, and frequency of the food I consume. For example
Breakfast         Use scales to weigh                40g Shreddies Cereal /180g milk
Lunch               Previous knowledge                2 slices of bread, apple, crisps
Snack               Check label                              Mars Bar 
Evening meal  Estimate using photo/ label     Naan Bread.
                        Use scales for                          Basmati rice,
                        Estimate using photo              Mango chutney

I find it is just not possible in today’s fast paced varied lifestyles and food environments to weigh everything. Therefore I use food portion size estimate in my daily routines. It is especially useful for those foods eaten less frequently or which I am less familiar. I find estimation vital to maintain the variety of the food choices I want to be able to make. As a foodie the thought of not eating something because of my pancreatic status, does not really enter my head. The principle that I will not let it beat me prevails.

Trying to stay in good control and eat as a person with diabetes has some limitations and barriers to overcome calculating carbohydrate load;

  • It is practically impossible to weigh all foods you consume.
  • Not all manufactured foods have nutritional labels E.g. Bread baked in supermarkets
  • Nutritional contents of foods are not readily available in most food service outlets (although some of the fast food outlets are getting better at detailing nutrient contents. But who wants to eat at the shit in a tray merchants anyway. © Mike Skinner The Streets)
  • Carbohydrate contents of foods made my others e.g. food made by friends does not usually have carb load readily available.

So the need to estimate food portion sizes in today’s modern food landscape is, for me, a necessity. Without it I would be back to yesteryear eating regimented amounts of carbs per meal with no or little amount of variety and restricted food choices. As food plays such a big part in my home and work life this would be horrendous to me. The joy I get from the different types and varieties of food I consume, plus the desire to constantly seek out new foods and cuisines, is facilitated in part, by the ability to estimate portion sizes of foods.


In a nut shell I am a great advocate of portion size estimation to facilitate the variety, amounts, and variation in food choices I can make. I do not think you can ever be 100% accurate, however when used in conjunction with other strategies such as scales, labels, previous knowledge, it can be a very powerful tool to allow a whole range of foods to be explored that would otherwise be difficult if not prohibitive to eat.

Examples of eating occasions where I find carb counting difficult and portion size estimations come to the for:

  • Eating outside of my home -  restaurants, work place, most food outlets
  • Foods prepared by others e.g. recent one was homemade bread at a friends house
  •  Takeaway fast food
  • Celebration events, weddings, birthdays, xmas, work do’s
  • Unfamiliar foods on holiday
  • Fruit
  • Anything that involves alcohol and food

Increasingly thanks to the success of patient education and empowerment programs such as DAFNE (Dose Adjustment for Normal Eating) counting carbohydrate portions is coming increasingly popular as the method of matching insulin requirements to carbohydrate load of food consumed. In fact the counting of carbohydrate portions has been around since the 1920’s.

In principle this method is excellent, can be taught by Health Care Professionals (HCP’s), and supported by a increasing range of tools to help us to estimate, monitor and track our carbs consumed. These include diaries, apps and portion books. 

With the advent of the Smartphone and the virtual 100% use of mobile technology, the need to constantly carry a portion estimation book, has been removed. This was always a barrier for me in the past. However now the levels of data I need to carry out estimations can be stored on a app on my phone (I carry every where with me anyway) and thus is easily available. This facilitates less guestimates and the increases the types of foods I can consume and where I can consume them. For me this has released me from the barrier of getting the portion book out every time you want to eat. 

After a relatively short period of time I built up the skills and experience to regularly be successful at estimating portion sizes using photographs, thus improving control and reducing those highs and lows by reducing the grey area when otherwise a guestimate would be used. Or a “I cant really eat that” decision is made.

The developments of products like;

utilise ranges of portions sizes and aid estimation of carbohydrate loads

The bottom line is that using portion size estimation tools allows me the flexibility to eat what I want, when I want, how I want, where I want and with whom I want. This is hugely empowering and satisfying in my food choices and is a major factor in keeping me happy and healthy.

Note – I have no involvement with any of the above tools. They are provided as links to things that have helped me maximise my food types and portion size variations.

1 comment:

  1. Balance diet is the essential part of diabetic treatment to stay fit while the patient is suffering from the diabetes and taking the food that has lots of fiber may prevent from further damage.

    Diets for diabetics