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So What’s Low Carb? Chapter 4 – Part 8

The Diabetes Diet
Richard K. Bernstein, MD, FACE, FACN, FACCWS
Part 8 of Chapter 4
So What’s Low Carb?

As you now know, virtually all packaged foods bear labels that reveal something about the contents; you also know that the FDA requires the labels of packaged foods to list the amount of carbohydrate, protein, fat, and fiber in a serving. Be sure, however, to note the size of the “serving.” For some foods, the serving size is so small that you wouldn’t want to be bothered eating it. The FDA explains that the nutrition labeling law “defines serving size as the amount of food customarily eaten at one time. The serving sizes that appear on food labels are based on FDA-established lists of ‘Reference Amounts Customarily Consumed Per Eating Occasion.’” You might think, for example, that a single bottle of soda would be considered one serving. Look again. If it’s an 8- or even 12-ounce bottle, you’d be right. But the regulations allow manufacturers some wiggle room, and some 20-ounce bottles list the contents as three servings. In my opinion, this latitude can be used to mislead without being legally dishonest.

Beware of labels that say “lite,” “light,” “sugar-free,” “dietetic,” “diet,” “reduced-calorie,” “low calorie,” “low fat,” “fat-free,” and even “low carbohydrate.” Although the Nutrition Labeling and Education Act establishes standards for some of these categories, and likely will soon adopt a standard for “low carbohydrate,” that standard, like the rest, will likely be essentially meaningless for those who are diabetic, overweight, or obese and in need of particularly clear information about what’s in what they eat.
These tags can be used as smoke and mirrors to distract you from the hard facts.

There are several things to keep in mind:

• Counts of calories are only going to tell you so much, as discussed on page 41.

• “Low fat” tells you nothing about carbohydrate content.

• “Fat-free” products — desserts and similar products— frequently contain considerable fast-acting carbohydrate to make up for the loss of flavor from he absent fat.

• Even if you’re losing weight, carbohydrate intake will impede your efforts much more than fat will. Two recent studies showed that when dietary carbohydrate is very low, dietary fat is metabolized, not stored. (On occasion I see slim patients whose desire is to gain weight. I’ve found that it’s impossible to put weight on those who are following a low-carbohydrate diet even by giving them 900 extra calories a day in the form of 4 ounces of olive oil.)

• Use common sense about nutrition facts claims. The common way to estimate the carbohydrate content of a particular food is to read the amount stated on the label. “Sugar-free,” remember, does not mean carbohydrate-free. As mentioned above, I know of a brand of strawberry preserves whose label claims, “Carbohydrate — 0,” and yet anyone can see the strawberries in the jar. Strawberries are mostly carbohydrate, so unless those are artificially flavored hunks of tenderloin made to look like strawberries (unlikely), common sense would tell you that the label is flat-out wrong. Deceptive labeling does occur and in my experience is fairly prevalent in the “diet” food industry.

Use Food Value Manuals
On page 52, I listed a few books that show the approximate carbohydrate and protein contents of various foods. These manuals are recommended but not essential tools for creating your meal plan. The meal plan guidelines in the next chapter, the recipes that follow, and the advice in the preceding pages are all you really need to get started. Those manuals are great when you’re creating your own recipes and want to get the carbohydrate and protein numbers.

My favorite is The NutriBase Complete Book of Food Counts, because it contains information on the most brands and is easy to use.

Food Values of Portions Commonly Used has been the dietitian’s bible for more than fifty years and is updated every few years. Be sure to use the index at the back to locate the foods of interest. Note that on every page in the main section, carbohydrate and fat content are listed in the same column. The carbohydrate content of a food always appears below the fat content. Do not get the two confused. Be sure to note the portion size in any books you use.

If you watch cooking shows, you’ve probably seen chefs who keep a computer handy while they’re cooking. If you’re electronically inclined, you can use the USDA’s nutrient database, which you can find on the Web by searching on the key words “USDA nutrient database.” The USDA now offers free software for the National Nutrient Database for Windows OS computers and for Palm OS personal digital assistants (PDAs) on both the Windows and Macintosh platforms. You can download the software at This has the potential to be a great tool for those who travel and carry PDAs.

We would like to thank the publisher Little Brown and Company and Dr. Richard K. Bernstein, for allowing us to provide excerpts from The Diabetes Diet.

Copyright © 2005 by Richard K. Bernstein, M.D. All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer who may quote brief passages in a review.

Author’s Note:
This book is not intended as a substitute for professional medical care. The reader should regularly consult a physician for all health-related problems and routine care.

For more information on Dr. Bernstein’s and to purchase his books, CD’s or get access to his free monthly webinars, visit his website at