Total Carbohydrates vs. Net Carbs: What Should People with Diabetes Count?
September 6, 2019
For people with diabetes, it's important to watch how many carbohydrates you eat at one time. If you’re following a carb-counting meal plan, counting carbohydrates is pretty easy if the food you’re eating has a Nutrition Facts Label. You simply find the grams of Total Carbohydrates listed on the Label and factor them into your meal plan. Simple, right? Not so fast.
Many products like Atkins, 647 bread, Halo Top ice cream, and Quest bars (just to name a few) list "Net Carbs" on their labels.
Net carbs = Total Carbohydrates - Fiber - Sugar Alcohols
These companies are suggesting that fiber and sugar alcohols have no impact on blood sugar. However, fiber and sugar alcohols still have calories (about 2 calories per gram). Because the body cannot completely digest them, some fibers and sugar alcohols are partially digested and absorbed. This means they still raise blood sugar.
American Diabetes Association Recommendations
If you have Type 1 Diabetes and do not use an insulin-to-carb ratio (ICR) or if you have Type 2 Diabetes:
- Count the Total Carbohydrates listed on the Nutrition Facts Label
- Do not subtract any fiber or sugar alcohols
If you have Type 1 Diabetes and use an insulin-to-carb-ratio:
- If fiber is AT LEAST 5g or more, you may subtract HALF the amount of fiber from the total carbohydrates
- Example: If your food has 20g of total carb and 5g of fiber, you can subtract 2.5g of fiber from the total carbohydrates = 17.5g Total Carb
- If your food has 20g of total carb and 4g of fiber, you don't subtract anything
- If sugar alcohols are AT LEAST 10g or more, you may subtract HALF the amount of sugar alcohols from the total carbohydrates
- Example: If your food has 20g of total carb and 10g sugar alcohol, you can subtract 5g of sugar alcohol from the total carbohydrates = 15g Total Carb
- If your food has 20g of total carb and 8g sugar alcohol, you don't subtract anything
Take Home Message
Net Carbs (unfortunately) is a term that was created by the food industry. There is not enough research to support counting only the "net carbs." Companies which promote net carbs also tend to send the wrong message: "I can eat as much as I want!"
Moderation is still key to managing blood sugars, so try to stick within your recommended carb intake per meal and snack. If you need help counting carbohydrates, see a registered dietitian who can work with you to make a meal plan.
Gabrielle Nichisti, RD, LDN
Gabrielle Nichisti, RD, LDN, is a registered dietitian with the Diabetes and Nutrition Center at Lancaster General Health.
Education: A graduate of the Pennsylvania State University, Nichisti values both education and counseling to connect with her patients. Passionate about leading an enjoyable, healthy lifestyle, Nichisti strives to help others overcome obesity, diabetes and heart disease.