Count Carbs Like a Pro—A Parent’s Guide

Count carbs like a Pro—A parent’s guide

Counting carbohydrates accurately is both a science and an art. One that takes time, practice and a lot of hard work. When parents master carb counting early on, it becomes second nature to the entire family and can lead to better blood sugars for your child with diabetes.

For some parents counting carbs can take an emotional toll. It’s a constant reminder that your child can no longer “just eat food” and be a kid. Instead, children and parents must become expert dietitians and mathematicians to count every single morsel of food and give insulin based on this estimation. And boy it’s hard! As a certified diabetes educator and type 1 myself, even I need constant refreshers on counting carbs.

In fact, research shows most people with diabetes count carbs inaccurately. A study published in Clinical Diabetes Journal, investigated carb counting accuracy in people with diabetes by having them take a carbohydrate test and guess the carb amounts in 18 different foods. The result was less than outstanding. The average test score of participants was 59 percent out of 100 percent—a failing grade by any standard! Despite the advances in technology, new insulin analogs and better treatments, carb-counting remains fairly unchanged since the 1920’s. You still need to count carbohydrates to better estimate insulin delivery.  But let me remind you why it’s so important to count carbs accurately.

Why does it matter?

• Studies show that people with better carb counting skills have better control. Both precision and consistency matter!
• Counting carbs is the best way of keeping blood sugars under control-better than limiting sugars, counting calories, or using an exchange system.
• Inaccurate carb counting can lead to low blood sugars or hyperglycemia by wrongly estimating insulin before meals.
• Adolescents with the most accurate carb counting skills (less than 10g off) had better blood glucose (BG) control and a lower A1C.

Parents, you are responsible for doing most of the work. For now, at least or until your child is developmentally ready to start counting carbohydrates and doing calculations on his/her own. Children as early as 6 years old can be introduced to the concept of carbohydrates: which foods contain carbs and what their portion sizes are. But don’t expect children to do all insulin and carb calculations until they are older.

There is a tendency for many parents is to get stuck on a set number of carbs per meal. In other words, I see parent’s counting the “same” amount of carbohydrates per meal as they did when their child was newly diagnosed. The reality is, carbohydrate amounts will change as kids grow up. Some days, carb intake will be more or less, depending on the activity. That is the one of benefit of counting carbs—it allows you more flexibility during meals and is not a fixed regimen.

Inaccurate carb counting is also associated with higher blood sugars after meals. If blood sugars are consistently above target after meals, a diabetes educator should assess your carb-counting skills. Although it’s impossible to be a “professional carb-counter,” you can become very good at “guestimating” correctly.

7 simple strategies to master carb-counting

1. Read the Label – This is the most practical way of counting carbs. Remember to focus on the total grams of carbs and not the sugars. (Sugars are a type of carbohydrate that is already included in the carb amount). Don’t fall into the “label trap” of only eating foods with a nutrition labels out of fear of miscalculating carbs. You might be missing important nutrients not found in a box, that come in fruits, legumes and veggies. Don’t be afraid to think outside of the box and learn other ways of counting carbs.
2. Have measuring cups in every day foods – Use measuring cups as spoons or serving utensils. By keeping the measuring cup inside the cereal box, you make a mental note to pre-measure the foods as you are serving. Also, do monthly checks by asking your children to put usual portions of cereal or pasta in a bowl and then place it in a measuring cup to estimate the true portion size.
3. Use a scale – By far the most accurate way of counting carbs is to use a scale. Great for estimating difficult foods that don’t always come with a label like fruits, lesser known grains, veggies and even baked goods. You simply weigh the food on a scale and multiply it by the individual carbohydrate factor. Thankfully, there are new scales that generate a nutrition label and you only need to look up the food. Have the scale in your dinner table; that way it becomes customary to count carbs before meals.
4. Create your own personal database – Most children eat similar foods each day. Create your own database by keeping a notebook at hand where you write down typical breakfast foods, favorite snacks and even combination foods like casseroles, soups and more.
5. Keep post-its in sight – For kids who are starting to learn how to count carbs, place post-its or visual labels on school lunch bags or unlabeled foods like trail mix, fruits, or homemade muffins.
6. Rely on technology – Thankfully, new apps have made counting carbs easier. You can even google any food to find the nutrition information, however, not all the information is accurate. Try using apps like Calorie King, My Fitness Pal, Fooducate, Figwee to help you keep count on carbs accurately.
7. Practice, practice, practice! – Yes, you can be a great nutrition label reader, but how useful is it when you go to a restaurant and have no clue how to estimate. In diabetes, practice application is often more important than theory. Practice at home, where you can measure food or use household items to help you train your eye in estimating portions. After a while, you will gain confidence and do the best educated estimation possible. After all, carb-counting is never perfect but it can be close to target and that’s what matters!

1. MeadeLT, Rushton WE. Accuracy of Carbohydrate Counting in Adults. Clinical Diabetes 2016 Jul; 34(3): 142-147. https://doi.org/10.2337/diaclin.34.3.142
2. Bishop FK, Maahs DM, Spiegel G, et al. The Carbohydrate Counting in Adolescents with Type 1 Diabetes (CCAT) study. Diabetes Spectrun 2009;22:56–62.

Read 10 Secrets for Getting Your T1 Kid to Eat.

WRITTEN BY Marina Chaparro, RDN, CDE, MPH, POSTED 03/29/17, UPDATED 12/28/22

Marina Chaparro, RDN, CDE, MPH, is a pediatric nutrition and diabetes expert. She is the founder of Nutrichicos—a bilingual children and family nutrition in Miami, FL and was formerly a spokesperson for the Academy of Nutrition and Dietetics. Marina has lived with type 1 diabetes since she was 16.