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Who doesn’t love a delicious bowl of pasta or rice? But over the years, carbohydrates have gotten a bad name. It’s hard to know what to eat! Understanding what carbohydrates are and how they affect blood sugar can help you create a healthy eating plan without cutting out your favorite foods. This page summarizes general information and recommendations from reliable sources and provides useful links about how eating carbohydrates can affect type 2 diabetes.

It is important to remember that everyone’s dietary needs are different. Not all the information below will apply to every person. Check with your healthcare provider if you have any questions about what foods are best for you to maintain a healthy eating plan.

What Are Carbohydrates?

Carbohydrates, along with protein and fat, are essential nutrients that are important for energy and to keep the body functioning.

There are three main types of carbohydrates, or “carbs”: starches, fiber, and sugar. On nutritional labels, “total carbohydrates” refers to how much of all three types of carbs are in the package. Every person needs a different amount of carbohydrates.

Starch (Complex Carbohydrates)

Starches are also referred to as complex carbohydrates. Starches provide more health benefits than simple carbohydrates for these reasons:

• They contain more vitamins, minerals, and fiber than refined carbohydrates
• They are digested more slowly.
• They have less of an immediate impact on blood sugar, causing it to rise more slowly.

Foods high in starch include the following:

• Starchy vegetables (peas, corn, lima beans, potatoes, winter squash)
• Dried beans, lentils, and peas (pinto beans, kidney beans, split peas, black-eyed peas)
• Grains (oats, barley, rice, pasta, bread, crackers)

Grains

Grains can either be whole or refined.

Grains contain three parts:

• bran: the hard outer shell that provides the most fiber, b vitamins, and minerals
• germ: middle layer packed with nutrients like essential fatty acids and vitamin e
• endosperm: soft, center part that contains the starch

Whole grain foods refer to when the whole plant is harvested and dried with little processing. They contain all three grain parts, meaning the food provides all the grain’s nutrients. Examples include oats, barley, bulgar, quinoa, brown rice, farro, and amaranth. At least half of your daily intake of grains should be whole grains.

Refined grain foods are grains that are processed to remove the outer layers of the grain leaving only the inner, endosperm layer. This means that all the beneficial fiber, vitamins, and minerals of the bran and germ layers are lost. When a label says “enriched,” it refers to essential vitamins and minerals being added back in during processing to replace the vitamins and minerals that were removed. When reading the ingredient list, look for products that list “whole grain” or “whole wheat” instead of “enriched.”

Fiber

Fiber comes from plant foods. When you eat dietary fiber, most of it passes through the intestines without being digested. When fiber passes through your digestive tract, it carries a lot of bad stuff out with it.

• For good health, adults should eat 25 – 30 grams of fiber every day.
• Benefits of eating fiber:
  • Good digestive health and helps keep you regular
  • Helps to keep you feel full and satisfied after eating
  • Helps to lower cholesterol, manage blood sugar, and reduce the risk of heart disease
• An excellent source of fiber contains five or more grams per serving; a good source contains 2.5 to 4.9 grams per serving.
• It’s best to get fiber from food rather than taking a supplement.
• It’s important to increase your fiber intake gradually to prevent stomach irritation.
• Remember to increase your intake of water and other liquids to prevent constipation.

Examples of dietary fiber:

• Beans and legumes (black beans, kidney beans, chickpeas, white beans, lentils)
• Fruits and vegetables, especially those with edible skin (apples, pears) and those with edible seeds (berries)
• Whole grains (quinoa, oats, bulgar, barley, farro)
• Nuts (peanuts, walnuts, almonds, pumpkin seeds, sunflower seeds)

Tips for selecting whole grains:

• Whole grain cereals: look for those with three grams of dietary fiber or more per serving. These include cereals made from whole wheat, whole bran, and oats.
• Whole grain breads: one slice of bread should have at least three grams of fiber. Look for breads with whole grain as the first ingredient like whole wheat or oats.
• Nuts: watch out for portion sizes: even small amounts contain a lot of calories.

Sugar

Sugar, another type of carb, is also referred to as simple carbs or fast-acting carbs.

Simple carbs are easily and quickly used for energy by the body, which often leads to a faster rise in blood sugar.

There are two main types of sugar: naturally occurring sugars (those found in milk or fruit), and added sugars (those added during processing like syrup in canned fruit or sugar added to cookies).

On nutritional labels, the amount of sugar grams listed includes both added and natural sugars. These are some different names for sugar:

• common names: table sugar, brown sugar, molasses, honey, beet sugar, cane sugar, confectioner’s sugar, powdered sugar, raw sugar, turbinado, maple syrup, high-fructose corn syrup, agave nectar, and sugar cane syrup
• chemical name: sucrose
• fruit sugar: fructose
• sugar in milk: lactose
• other sugars on labels have chemical names ending in -ose

Sugar Alcohols

Sugar alcohols are sweeteners that have about half the calories of regular sugar.

• Some occur naturally in certain fruits and vegetables
• Some are manmade and added to processed foods
• Many foods labeled “sugar-free” or “no sugar added” have sugar alcohols
• “Sugar-free,” “reduced sugar,” or “no sugar added” do not necessarily mean that foods are carbohydrate-free or lower in carbohydrate than the original version of the food

Sugar Substitutes

Sugar substitutes are sweeteners that contain little or no calories and have little or no impact on blood sugar.

• Since they are sweeter than sugar, they can be used in smaller amounts.
• Most cannot be broken down by the body, so they pass through our system without providing calories.
• These can be used as alternatives to sugar.
• At this time, there is no clear evidence to suggest that using sugar substitutes will help with managing blood glucose or weight or improving cardiometabolic health in the long run.

These are some examples of sugar substitutes:

• saccharin (one brand name: Sweet’N Low)
• neotame (Newtame)
• acesulfameK (Sunett, Sweet One)
• aspartame (NutraSweet, Equal, Sugar Twin)
• sucralose (Splenda)
• advantame
• stevia
• monk fruit extract (luo han guo)

Sugar substitutes are effective alternatives to sugar for some people, but not a perfect fit for all. Find out more from the American Diabetes Association about carbs and types of carbohydrates.

How Do Carbohydrates Affect Diabetes?

When you eat or drink foods with carbs, your body breaks down the carbs into glucose, which enters the bloodstream and raises your blood sugar levels. Carbs are an important part of a healthy diet. Remember to choose carbs that are high in fiber, vitamins, and minerals; limit carbs low in added sugars, sodium, and unhealthy fats, and portion your servings.

Below are some tips for eating carbohydrates:

• One serving of carbs (15 grams) may be smaller than you think. For instance, a serving is one-fourth cup of granola or six saltines. Carb counting can help manage blood sugar and make sure you’re eating a balanced diet.
• Eat the most of whole, unprocessed, non-starchy vegetables, such as lettuce, cucumbers, broccoli, tomatoes, and green beans. Such carbohydrates have a smaller impact on blood sugar that those that are more refined.
• Eat some of whole, minimally processed carbs. These include fruits (apples, blueberries, strawberries, and cantaloupe), whole, intact grains (brown rice, whole wheat bread, whole grain pasta and, oatmeal), starchy vegetables (corn, green peas, sweet potatoes, pumpkin, and plantains), beans and lentils (black beans, kidney beans, chickpeas, and green lentils)
• Eat the least of refined, highly processed carbohydrate foods and those with added sugar. These include sugary drinks like soda, sweet tea and juice; refined grains like white bread, white rice; and sugary cereal; and sweets and snack foods like cake, cookies, candy and chips
• When you eat a meal or snack with carbs, add some protein (meat, a small handful of nuts, or low-fat dairy) to help you stay fuller longer and avoid spikes in blood sugar.

Healthy swaps to consider:

• Eat whole fruits instead of juice.
• Reduce drinking sugar-sweetened beverages.
• Use whole wheat pasta, tortillas, and bread.
• Swap sugary cereals for old-fashioned or steel-cut oats.
• Explore different kinds of grains like quinoa, farro, bulgur wheat, barley, and millet.

The Glycemic Index

The glycemic index is a scale that can be used to indicate how quickly different foods can raise blood sugar levels. The glycemic index ranks carbohydrates on a scale from zero to 100, based on how quickly and how much they raise blood sugar levels after eating.

Foods with a high glycemic index, such as white bread, cause high spikes in blood sugar and foods with a low glycemic index, such as whole oats, cause a more gradual rise in blood sugar.

Glycemic index scale:

• Low: 55 or less
• Medium: 56 to 69
• High: 70 to 100

Factors that affect glycemic index:

• Processing: Removes the nutritional benefits from grains causing them to have a higher glycemic index than minimally processed whole grains.
• Physical form: Finely ground grain is digested more quickly than coarsely ground grain. Eating grains in their whole form, like brown rice or oats, can be healthier than eating highly processed whole grain bread.
• Fiber content: Foods that are high in fiber take longer to digest, which causes a more gradual and lower rise in blood sugar.
• Ripeness: Ripe fruits and vegetables tend to have a higher glycemic index than un-ripened fruit.
• Fat content and acid content: Meals with fat or acid take longer to turn into sugar.

Learn more about carbs and diabetes and from the American Diabetes Association (ADA), carbohydrates and blood sugar from The Nutrition Source, and choosing healthy carbs from the Center for Disease Control (CDC).

More Information

American Diabetes Association: Eating Well & Managing Diabetes | ADA

Mayo Clinic: Diabetes diet: Create your healthy-eating plan - Mayo Clinic

American Heart Association: What Is a Serving? | American Heart Association

Diabetes Food Hub: Diabetes Food Hub