Making Carbs Work for Diabetic Clients

Filed under: Business Strategies,Special Diets , Tags: , — Author: Caron Golden , July 11, 2016
Fig and barley salad2

Fig and Barley Salad

As some of you may know, I have Type 2 diabetes. This morning I enjoyed what has become a typical hot weather breakfast: a quarter cup of granola (15 grams of carbs) mixed with a half cup of nonfat yogurt (eight grams of carbs, plus protein), and a half cup of fresh blueberries (10 grams of carbs, plus fiber). That’s a total of 33 grams of carbs, less if you take into account the glycemic index, which measures how food with carbohydrates raises blood sugar. Blueberries, for instance, have a low glycemic count, thanks to its fiber, so it actually would give a net carb count of eight or nine grams. Add a teaspoon of honey and a bit of low-fat milk to my coffee and I top out at around 45 grams of carbs total for breakfast.

Confusing? Welcome to the world of Type 2 diabetes. Actually, confusing comes only at the beginning of the journey. Once you start tracking carbs it becomes pretty easy to figure out what and how much to eat at every meal. And as a personal chef with diabetic clients, you’ll get the hang of it quickly enough, too.

Carbs have developed a bad rap among the health-conscious public but it’s a vast overstatement to say they’re bad for you. Carbs are a source of energy thanks to the glucose that comes from sugars and starches they contain. Plus they can help reduce weight and prevent disease—assuming you choose the right kinds of carbs. Certainly a diet full of pretzels, pizza, beer, and pasta isn’t exactly healthful. But consider just how many foods that are good for you contain carbs—pretty much everything but meats and fats. So, we’re talking whole grains, fruits, beans, and legumes—food with fiber.

Einkorn salad

Einkorn salad

In a healthy person, the body breaks down the sugars and starches that make up carbs into glucose which goes into cells for energy. For people with Type 2 diabetes, glucose, or blood sugar, builds up in the blood instead of going into the cells, which over time can damage your heart, eyes, and kidneys. The challenge for people with Type 2 diabetes is figuring out how much to consume anytime we sit down to eat so our blood sugar levels don’t skyrocket. For example, fruit juice is pretty much out. Think about it. One medium orange contains 15 grams of carbohydrates and goes down to 12 net carbs thanks to the fiber in the orange. But one cup of orange juice contains 26 grams of carbs. You’re better off eating a whole orange and get the reduced carbs and increased fiber than swig a glass of juice.

Blood oranges

There’s also a common assumption that people with Type 2 diabetes can’t eat sugar. But they’re stuck in the mindset of refined sugar and forget that sugar naturally occurs in foods like fruit and milk. So, with the best of intentions your client may be offered a big bowl of fruit in lieu of a slice of cake. But while the fruit is healthier, she must still need to limit the amount she can eat.

So, how do you help clients get carbs to work for them? Here are a few techniques I’ve learned that have helped me over the years:

  • Go for high fiber. Instead of white rice, serve brown rice. Instead of conventional pasta serve whole wheat pasta. Scout out whole grain cereals. Serve whole wheat sourdough bread, which, thanks to the lactic acid that creates that tangy sour flavor, also makes it low glycemic. Prepare whole grain sides like farro, freekah, wheat berries, barley, buckwheat, and wild rice—turn them into salads with roasted vegetables. Use fresh cauliflower, pulsed in the food processor, to make faux rice.
  • Limit portions. How do I know how much I can eat? I took a nutrition class at Kaiser Permanente after I was diagnosed. There I learned that 15 grams of carbs is one serving (regardless of the type of carb). According to the nutritionist, a woman trying to lose weight should have three servings of carbs per meal; a man should have four. To maintain weight, a woman should have four servings at each meal, plus one as a snack; for men it’s four to five. And for the very active, the number of servings goes to six per meal for women and five to six for men. With that, you just do the math with a carb-counting guide and reading nutrition labels on packaged foods. But typically a serving of carbohydrates would be a slice of whole grain bread, a third of a cup of cooked pasta or rice, three-quarters of a cup of cereal, a six-inch corn tortilla, or a half cup of corn, green peas, or beans.
  • Shop small. It’s good to eat bananas, but look for very small ones because who wants to eat the leftover half the next day? Shop for small apples and peaches and tangerines. Does your client crave a baked potato? Search for small russets so he can have the satisfaction of eating a whole one without overdoing the carb count. Five ounces is 24 grams of carbs—enough to account for other vegetables and also have fruit for dessert. If you can’t find them (most markets usually go for giant size) bake a red or Yukon gold. Or bake a small sweet potato, which is rich in fiber.

Your client may miss his pizza and big bowls of pasta for awhile, but if you can create meals that are flavorful and have some of the qualities of what he used to indulge in, only in healthy portions, he will find that he loves the new way he consumes carbs–relishing the deep flavors and textures from whole grains or the joy of indulging in a small juicy nectarine or bowl of strawberries. And you’ll have fun testing your creativity, too, as your client enjoys better health and more energy!

Do you have a client with Type 2 Diabetes? What kinds of dishes are you creating that have addressed the carb issue?

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apple crisp1

When a client has type 2 diabetes, creating a healthy dessert can be a tricky thing. What everyone immediately fixates on is the sugar. But sugar is really a foil for something larger, which, of course, is carbohydrates. And all carbs are equal when it comes to diabetes management. The other component just as important in managing diabetes is fat. For most people with type 2 diabetes, excess weight is what led to the disease. Keeping weight in check through a healthy, low-fat diet along with exercise—and managing blood sugar through carb control—is what will help those with type 2 diabetes stay healthy in the long run.

Now that we’re smack dab in the holiday season, where does dessert fall into a healthy diet? Dessert is an indulgence, a part of the pleasure of a day. But the person with diabetes has to plan for it. My experience has been that it’s all about moderation and portion control—and they’re not necessarily the same thing.


Moderation includes portion control but it also means being discriminating in what you eat. In the context of dessert, it means looking for sweets that are mostly made with real fruit or dark chocolate. It means seeking out desserts that are airy—made with lots of egg whites, like angel food cake and sponge cake—which cuts down on the density and carb count. Or simply desserts which call for less sugar than conventional recipes.

Portion control can be tricky. So one approach is to look for desserts that are by their nature single portion: chocolate mousse servings in a small ramekin, a single piece of dark chocolate, a small honey crisp apple. If a client is craving pie or cake you can slice it into individual portions, wrap them, and put them in the freezer. Same with cookies or muffins.

Pudwill Berry Farms Honey Crisp Apples2

I know there are a lot of people who look for sugar-free choices. But what you have to remember about sugar-free options is that they aren’t necessarily lower in fat or carbs. And they usually include chemicals we may not want to consume. It’s better to eat natural ingredients. Yes, there are healthier sugar-free options; honey and maple syrup are favorites and many people love stevia. For a long time, agave nectar was considered a good alternative to sugar but doctors like Andrew Weil are now concerned about the impact of high fructose and are discouraging its use.

Sometimes your client just wants what she wants and you have to figure out how to make it work. Does she love apple pie? How about ditching the crust and instead make a crisp? By reducing the amount of butter, sugar, and flour—and eating small portions—she can have something healthier since it’s just topping cooked fruit, not encasing it. You can even make a bag of crisp mixture, store it in the freezer, and she can pull out a handful at a time to top a sliced apple or cup of berries.

Ultimately, it’s all about balance. Balancing carb portions, balancing fat and calories, balancing exercise with relaxation, balancing indulgence with healthy choices. Dessert isn’t something you have to cut out so much as balance with everything else you’re doing to stay healthy.

Caron Golden’s Crisp Mixture

What I love about this recipe is that I can make the mixture in advance and store it in the freezer. Then I can create an individual serving for myself or a large dessert for company, using whatever fruit is in season. In cool seasons, I peel, core, and slice a Granny Smith apple. Then I toss the slices in a small amount of flour and sugar, and place the slices in a large ramekin or individual pie dish that I lightly coated with baking spray or vegetable oil. I’ll pull out the crisp mixture from the freezer and spoon out just enough to top the fruit, then bake. In less than an hour I have a pretty healthy, fiber-rich dessert.

Makes 8 to 10 servings, depending on how much you use per serving

Mix together:
2 cups quick cooking oats
1 cup toasted walnuts, chopped
1 ½ cups lightly packed brown sugar
2 cups all-purpose flour
½ teaspoon salt
1 teaspoon cinnamon
½ teaspoon fennel pollen
1 cup unsalted butter, melted

Store in the freezer until you’re ready to bake.

crisp mixture

Pre-heat oven to 350 degrees. Prepare fruit. Toss with a little flour and sugar. Arrange in a baking dish lightly coated in baking spray or vegetable oil. Top with enough crisp mixture to cover the fruit. Store remaining crisp mixture in the freezer.

Raw apple crisp

Bake for about 40 minutes or until fruit is bubbly and the topping is browned.

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