Firstly. Food labelling is an excellent initiative. We get the information we need about ingredients and the nutritional composition of our food. There is nothing wrong with food labels. But they are very misleading if we don’t know what we are doing. If the food labels were simply information, that would be perfect. But unfortunately, the dead hand of the retail industry has infiltrated the system. We have the front of pack labelling to give us a quick reference. Those traffic lights to inform us of the health-giving properties of the food. And the recommended daily allowance of each food group. There is something here for T1, but we need to know where to look.
The RDI or Recommended Daily Allowance is based on the current dietary guideline recommendations. That is to say, they are based on the low fat, high carb diet. This is a diet where 55% of energy is derived from carbs. That is a whopping 300g per day. We are looking at a Keto RDI of 50g per day. So, the RDI does not fit our needs for the fat and carbs. Ignore them.
Worse for T1 keto is the traffic-light front of label information. Green for low fat, green for high carb. That doesn’t suit T1 looking to get good control of their blood glucose. And more problematic for T1 who are not experienced in food labels is the section on the front of the label that refers to sugars. It means sugar. Added sugar. It has no meaning regarding carbs. Sugar and carbohydrates can be separated into separate entities on food labels. Unfortunately, the body is unable to do this. All carbs end up as sugar when digested. All starchy carbs end up as glucose. Separating sugar and carbs is not at all rational for people with Type 1 diabetes. 100g of porridge has 65g of carbs on the back of the label. But it states less than 1g of sugar on the front label. All carbohydrates break down into sugar. So, if we impulse-buy based on sugar, we are going to get caught out. Fair enough, the sugar is on the label to advise us about refined sugar. Because currently, there is a drive to limit our added sugar daily intake. But it is not helpful to people with Type 1 diabetes. For Type 1’s looking to go very low carb, we need to ignore the front of the pack. Turn it over and look at the back.
There, we need to look at carbohydrates. Carbohydrate is the number one ingredient that causes trouble for Type 1. Carbohydrates are mostly sugars. Starchy carbs are simple sugar molecules joined together. So, potatoes, bread, cereals, are virtually sugars but have to be converted to sugar by the body. That is done in the digestive system. By the time bread gets to the bloodstream, it is sugar. The body has no clue whether it is sugar from ice cream or potatoes. It detects sugar. Root vegetables contain sugar as do leafy green vegetables but in lesser amounts. Vegetables are crunchy because of cellulose in the leaves and roots. It is sugar. However, some of the crunchiness comes from poorly digested carbs called fibre. More of that later.
So, when you go to buy a pack of food, go straight for the nutrition label on the back.
You have wisely ignored the claims on the front of the pack. But go back and take a quick look at the sugar content. Here is an example, 8g of sugar per serving. That seems low for a cereal. Then take a look at the serving size. 30g. You will probably not be buying this food if you have Type 1 diabetes and are looking for very low carb. But weigh out 30g of breakfast cereal and look at the tiny amount in the bowl. No one eats that little. Especially a teenager. Serving size is one cheeky way for the manufactures to make sure they get the figures right. It is something to be aware of.
Now, turn over and look at the back of the pack. Find the line for total carbohydrates. The total carb will be your entire sugar intake from this food. It is best to look at the amount per 100grams of food. You will then get a feel for the exercise and be better able to compare foods. There are 23g of
carbs in a portion in this example. That is the sugar load you would get from this cereal even before you added the milk, ( but there are not many carbs in milk). There are 8g of sugar on the front label, 23g of carbs on the back. That is nearly three times the amount. Just 30g of this cereal would give you around two-thirds of your daily carb amount. If you did not have T1 and were looking for 100-150g of carbs per day, this might be a good option for you.
While you round the back of the pack, take a look at the ingredients. Do you recognise the names of the ingredients? Do they seem like food? Are there added sugars? Are there added processing chemicals that extend palatability and shelf life? Are there added vitamins? If these are all present, it’s best to avoid them. We do all like an unhealthy treat from time to time. It’s a personal choice in the end. Remember the adage. ‘It’s not what you eat between Christmas and the New Year that matters. But what you eat between the New Year and Christmas. You get the idea.
Total carbs in the UK is just that. Total carbs in the product that is likely to be digested. In the UK, fibre is separated and quoted separately. So, if it says 60g of carbs on the label, you get 60g of carbs absorbed. Net carbs is a USA labelling of carbs. To get to net carbs, you take the total carb and subtract the fibre. For practical purposes and especially for low carb where carbs will make up a small part of the diet, use total carbs. The other complicating factor in all of this is the GI. That is the time taken for blood glucose to spike after a meal of just that food. The idea is that the lower GI, the less likely you are to get a sugar spike as the glucose will be absorbed more slowly. This is more a tool for people with type 2 diabetes. If you are on a very low carb diet, it’s okay to ignore GI unless you are going to have all your daily carbs in one go. Fortunately, the vast majority of real food is low GI by nature.
There is one product used in low carb diets as a sweetener. This is a sugar alcohol. It is sweet to taste and is 100% carb but is not absorbed. They can vary in absorption, and some sources recommend allowing for half the carbs quoted for sugar alcohols. As a rule, it’s good to should aim to reduce artificially sweetened foods. But if you use sugar alcohols, which are also called erythritol and xylitol, then these carbs will not necessarily affect your blood glucose. But in some people, it does. It seems that erythritol is the least likely to affect blood sugar. But everyone should experiment on their way to mainly giving up sweeteners—Pet alert. Sugar alcohols are harmful to dogs and cats.
Fructose or fruit sugar is a sweet-flavoured type of sugar. Fructose does not affect blood sugar levels. It is present in fruits. The quantities of fruit eaten with a very low carb diet will contain glucose and fructose and will be counted as total carbs. But in practice, only small amounts of fruits are consumed on a very low carb diet. For fruits, count total carbs. Fructose in refined sugar such as table sugar and high fructose corn syrup is another story altogether. Because we are avoiding refined sugars, we can leave it there.
Most of the food eaten with any diet should be a real, nutrient-dense, whole food. A diet that your great grandmother would eat. It will not have been processed.
A lot of these fresh products have no food labels. In this case, go to an app such as myfitnesspal.com and get your information there. Once you get used to it, you will not have to think twice. You will get a good knowledge of the carbs in the foods you eat frequently. For a start, keeping lists and adding up the daily total of carbs will be necessary, but with time it becomes second nature. The idea is to enjoy real nutrient-dense food as part of a very low carb lifestyle. It is not about becoming label obsessed.