Carb Counting/Reducing
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Mandi98U
Posts: 115 Member
I was recently diagnosed with Diabetes and my primary care doctor said that he would like to see me only eating 3 servings of carbs a day. I met with him 1 week after my diagnosis and before that I had bought foods that I thought would be good choices for me but found out that most of them have more than 1 serving of carbs in them, so I chose to eat the things I bought and when they were gone cut down to the 3 servings of carbs a day (45 grams). Now it is time for me to cut down to the 3 servings a day when I have consistently been eating 6-7 servings of carbs a day (staying within my calorie deficit)I’m looking for advice on how to cut my carbs down. Some more general information about me since Sept 25th I’ve lost 18lbs, I’m currently 305 pounds, 5ft7 and I am 21years old. (I should also specify that due to other health reasons I can’t do the Keto diet as it is high in fat)
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Replies
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You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.5 -
Agree with the above - if you can't eat fat, and can't eat carbs, you won't be left with much to eat. A RD could help you develop a better eating plan, and would be well worth the investment for your longer term health.5
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How to cut down depends on what you like to eat...
Wraps or sandwiches can be made with just lettuce instead of bread.
You can use a poached egg for a round sandwich bread - and while the texture is different, this works great for breakfast sandwiches, just add sausage or bacon and some cheese since you already have the egg flavor.
If you google "keto cereal" you fill find recipes for cereals that can be made that are low carb.
Cauliflower rice instead of regular rice.
Zucchini noodles or shiritaki noodles instead of pasta.
You can make "crackers" out of baked quartered cheese slices for snacks...or just snack on cheese/pepperoni.
Herb teas like raspberry and blueberry make a good substitute for juice, and you can use artificial sweeteners if you want them sweet.1 -
You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?2 -
Definitely get a referred to a dietitian- a lot of ties the local hospital can provide you with the right information and will be off a great deal of help. Diabetes is serious and you need someone trained who can help with your own specific issues-good luck0
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Oh and one other thing. Your doctor may be enamored with low carb weight loss instead of just helping you manage your condition as you continue to lose weight.3
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My calorie limit is 1800, and yes the doctor said 45 grams of net carbs per day. I understand how to calculate net carbs and even after calculating the net carbs I am eating about 6-7 servings, currently. There is no set limit on how much fat I can have but the Dr. advised me that Keto would not be a great idea because I recently had my gall bladder removed so my body is still relearning how to process fat. As helpful as a dietitian would be they do cost money and my insurance covers primary care visit they don’t cover dietitians.You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?
3 -
You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?
My calorie limit is 1800, and yes the doctor said 45 grams of net carbs per day. I understand how to calculate net carbs and even after calculating the net carbs I am eating about 6-7 servings, currently. There is no set limit on how much fat I can have but the Dr. advised me that Keto would not be a great idea because I recently had my gall bladder removed so my body is still relearning how to process fat. As helpful as a dietitian would be they do cost money and my insurance covers primary care visit they don’t cover dietitians.
You are necessarily going to eat almost as much fat as on keto, which is why the advice seems weird and a dietitian would be helpful.
A good 45 g + 25 g fiber = 70 g carbs.
A good protein goal would be at least 0.8 g per lb of a healthy goal weight (say, 145) or 116 g.
That totals 744 -- rounding to 750, that leaves 1050 for fat or about 117 g.
Overall this would work out to about 15% carbs, 25% protein (30% is certainly fine too if you don't find it difficult), and then around 55-60% fat.
How to do that? Approach it somewhat like a very low carb diet, and assume you are getting most carbs from sources with some fiber like non starchy veg and higher fiber fruits (like raspberries) or other lower cal fruits. Avocado will be good, nuts and seeds. You can likely fit in very small servings of starchy carbs like potatoes at one of your meals (100 g of uncooked potato, which I think is a reasonable serving, has about 15 g carbs).
Finding a lower carb breakfast can be the difficulty for some -- I would approach it meal by meal.
Foods like spaghetti squash or even other winter squash, turnips and other non potato root veg, and options like cauliflower rice could possible substitute for the starch portion in some of your meals at least until you get used to not having them.
I have to note, however, that many with T2D are able to control it and lose weight and go into remission without following such a low carb diet -- doing more like under 150 or 100-120, and just making sure they eat moderate portions of carbs with fiber along with protein and fat at their meals. Talking to a trained diabetes educator has helped a number of people here. Often you can get a referral and it will be covered by insurance.1 -
We've seen so many threads here with unclear dietary advice from MDs...
Your carbs are keto-low but you're not supposed to eat keto amounts of fat, so that would leave you filling in the gap with an unusually high amount of protein. Count me as another vote for getting a referral to a registered dietitian or a trained diabetes educator. An RD or DE would best help you unravel this.3 -
HoneyBadger155 wrote: »Agree with the above - if you can't eat fat, and can't eat carbs, you won't be left with much to eat. A RD could help you develop a better eating plan, and would be well worth the investment for your longer term health.
Protein.
T2D responds well with higher protein diets and in fact may benefit more with more protein to combat the catabolic effects of diabetes, in general, and aiding in fat loss, which would ease the insulin resistance a bit.
https://www.ncbi.nlm.nih.gov/pubmed/304315861 -
My calorie limit is 1800, and yes the doctor said 45 grams of net carbs per day. I understand how to calculate net carbs and even after calculating the net carbs I am eating about 6-7 servings, currently. There is no set limit on how much fat I can have but the Dr. advised me that Keto would not be a great idea because I recently had my gall bladder removed so my body is still relearning how to process fat. As helpful as a dietitian would be they do cost money and my insurance covers primary care visit they don’t cover dietitians.You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?
The problem is you need the RD so you don't mistakenly think your doctor is giving you sound nutrition guidance. If an RD is not an option then go back to your doctor and tell him/her that based on your research his/her carb guidelines are too strict and it could hinder your weight loss. That is unless you enjoy the idea of eating grilled chicken or lean fish all day to fill your calorie requirements.
Are you even on insulin yet?0 -
My calorie limit is 1800, and yes the doctor said 45 grams of net carbs per day. I understand how to calculate net carbs and even after calculating the net carbs I am eating about 6-7 servings, currently. There is no set limit on how much fat I can have but the Dr. advised me that Keto would not be a great idea because I recently had my gall bladder removed so my body is still relearning how to process fat. As helpful as a dietitian would be they do cost money and my insurance covers primary care visit they don’t cover dietitians.You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?
The problem is you need the RD so you don't mistakenly think your doctor is giving you sound nutrition guidance. If an RD is not an option then go back to your doctor and tell him/her that based on your research his/her carb guidelines are too strict and it could hinder your weight loss. That is unless you enjoy the idea of eating grilled chicken or lean fish all day to fill your calorie requirements.
Are you even on insulin yet?
I am not on insulin, the dr said that I am just barely diabetic (whatever that means) and all of my sugar readings have been in the healthy range since I started testing them 2-3 weeks ago. That’s why I’m not sure if I even need to worry about reducing my carbs down to 3 net servings a day when eating 6-7 net servings has my blood sugar readings appearing normal.
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My calorie limit is 1800, and yes the doctor said 45 grams of net carbs per day. I understand how to calculate net carbs and even after calculating the net carbs I am eating about 6-7 servings, currently. There is no set limit on how much fat I can have but the Dr. advised me that Keto would not be a great idea because I recently had my gall bladder removed so my body is still relearning how to process fat. As helpful as a dietitian would be they do cost money and my insurance covers primary care visit they don’t cover dietitians.You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?
The problem is you need the RD so you don't mistakenly think your doctor is giving you sound nutrition guidance. If an RD is not an option then go back to your doctor and tell him/her that based on your research his/her carb guidelines are too strict and it could hinder your weight loss. That is unless you enjoy the idea of eating grilled chicken or lean fish all day to fill your calorie requirements.
Are you even on insulin yet?
I am not on insulin, the dr said that I am just barely diabetic (whatever that means) and all of my sugar readings have been in the healthy range since I started testing them 2-3 weeks ago. That’s why I’m not sure if I even need to worry about reducing my carbs down to 3 net servings a day when eating 6-7 net servings has my blood sugar readings appearing normal.
If I'm understanding you, a serving is 15 g net carbs, so 6-7 would be 90-105 g net (and likely 115-130 g total), divided into 3 meals. That's totally within the realm of what is more commonly recommended by dietitians and diabetes educators, and so if it seems to be working, you are losing, and the high fat diet contradicts with other issues, then I think that's a better option, especially since many doctors are clueless about nutrition, give extreme advice thinking people will only halfway comply, and did not give you more detailed advice.4 -
My calorie limit is 1800, and yes the doctor said 45 grams of net carbs per day. I understand how to calculate net carbs and even after calculating the net carbs I am eating about 6-7 servings, currently. There is no set limit on how much fat I can have but the Dr. advised me that Keto would not be a great idea because I recently had my gall bladder removed so my body is still relearning how to process fat. As helpful as a dietitian would be they do cost money and my insurance covers primary care visit they don’t cover dietitians.You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?
The problem is you need the RD so you don't mistakenly think your doctor is giving you sound nutrition guidance. If an RD is not an option then go back to your doctor and tell him/her that based on your research his/her carb guidelines are too strict and it could hinder your weight loss. That is unless you enjoy the idea of eating grilled chicken or lean fish all day to fill your calorie requirements.
Are you even on insulin yet?
I am not on insulin, the dr said that I am just barely diabetic (whatever that means) and all of my sugar readings have been in the healthy range since I started testing them 2-3 weeks ago. That’s why I’m not sure if I even need to worry about reducing my carbs down to 3 net servings a day when eating 6-7 net servings has my blood sugar readings appearing normal.
I can't give you medical advice but I can strongly encourage you to advocate for your own health. It is very important that you lose weight without additional hindrances that are not 100 percent necessary. I have had 4 different medical professionals try to change how I lose weight to something they thought was better. I ignored them all.
I would poke around the nutrition section of the ADA site and get information so that you can ask your doctor pointed questions.
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Keto does not have to be high fat. I am keto and my protein is higher than fat. I am doing nutritional keto not medical keto; a big difference. Nutritional keto is low carb, high protein and fat is a lever, meaning fat is added if you are still hungry. Medical keto is low carb, moderate protein and high fat - this diet is a treatment for severe epilepsy.2
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My calorie limit is 1800, and yes the doctor said 45 grams of net carbs per day. I understand how to calculate net carbs and even after calculating the net carbs I am eating about 6-7 servings, currently. There is no set limit on how much fat I can have but the Dr. advised me that Keto would not be a great idea because I recently had my gall bladder removed so my body is still relearning how to process fat. As helpful as a dietitian would be they do cost money and my insurance covers primary care visit they don’t cover dietitians.You should get a referral to a registered dietitian. Doctors are not normally well trained in nutrition and their advice can be hard to interpret/follow. Plus if you have additional medical problems with fat you really need an RD to help guide you.
Generally speaking it is not the number of servings more than the net total of carbs (total carbs - fiber) that you have to watch.
I agree with this.
Is the doctor saying you should eat no more than 45 carbs per day, 15 g per meal? Is it net carbs? 45 g carbs is keto level, really, certainly if not net and likely even if net at your height and weight.
Do you have more information on calorie level and fat limits?
This is why a dietitian would be helpful. Did you doc clarify what kinds of carbs? I am wondering if he was meaning specifically things containing grains(baked goods of all varieties) and not veg and fruit. And without further clarification from him, if it were me, I would continue to bulk up my meals with all the veg and fruit I needed within my allotted calories.
FWIW, I do eat keto for migraine control. But it concerns me that he would have you cut carbs so low when your body does not process fat effecently at the moment.
ETA: the poster above me is also how I keto. High protein, low carb, fat falls wherever after my meat, dairy selections, and oils for cooking veg.0 -
I don't have really any advice for you. But I do have some thoughts regarding foods you might find you like. I have found a huge love for chaffles! That is egg/cheese made on a mini waffle maker. If you use mozzarella and egg the taste is like a crunchy toasted piece of bread. Cheddar and egg is like a yummy biscuit. Cottage cheese and egg is like a pancake. Cream cheese and egg like a pancake or dessert if you add Splenda or something. I eat some combination of this daily. I just enjoy them! They have replaced all breads for me.
When I tried to limit my carbs I started eating more veggies. I actually found that I actually liked some vegetables I never thought I would like. I also added things like mushrooms for bulk to help with a filling meal without the fat/carbs/calories. Also things like cauliflower can be made in all kinda ways and since its typically bland it can take on most any flavor you are wanting.
Good luck! I know you can do this!!!! Just play around with foods that mimic what you miss.0 -
I was type 2 diabetic before I lost the weight. Like you I was not on insulin but I was taking Metformin. I had been overeating on carbs (mostly candy) for years. My doc was a fan of low carb diets but I chose how I would lose. Once my weight came down I went off the Metformin and my sugars are normal. I can't do Keto either because it gives me crazy diarrhea since I have no gall bladder. It's not worth it. What I have found to be true in my case is that I do better if I avoid the refined carbs most of the time. I still eat fruit and veggies which have lots of carb in them but less bread and pasta. I do indulge occasionally but just not regularly like I used to. My doctor is thrilled with my progress. I agree with @NovusDies that you need to do what works for you.2
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Dkenya2017 wrote: »Keto does not have to be high fat. I am keto and my protein is higher than fat. I am doing nutritional keto not medical keto; a big difference. Nutritional keto is low carb, high protein and fat is a lever, meaning fat is added if you are still hungry. Medical keto is low carb, moderate protein and high fat - this diet is a treatment for severe epilepsy.
Keto pretty much does have to be high fat, as there's only so much protein one can eat, and you get energy from either fat or carbs so a very high protein, moderate (like 35%) fat, super low carb diet isn't actually a good idea.
If you mean you eat more grams of protein than fat, that's not saying much, since fat has more cals per gram. When I did a keto-ish way of eating I ate about 100-120 g of protein, 60 g of carbs (but 25+ g fiber, so more like 35 g net), and then fat for the rest -- since that's only about 640-720 cals of from carbs + protein, that was still over 60% fat (I was at maintenance, and that means 1800 cal if not exercising, and over 2000 cal if I am, which I mostly was), which is definitely high fat.
If I'd eaten at the high end of the protein and been trying to lose (say at 1500 cal), my numbers would have been 120 g, 60 g, and 87 g of fat, but that would have been 52% fat, which is most definitely considered a high fat diet -- and as noted my carbs were quite a bit higher than what seems to be recommended or adopted by many doing keto.3
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