# 'carb counting' protein and/or fibre?



## Patricia (Aug 20, 2010)

Been meaning to ask this for a while...

It's quite common in the US I think to dose for protein (eg an egg equals 5 grams CHO etc). Esp for children?

Also, it's very usual of course to 'subtract' the grams of fibre from the grams of carb and thereby arrive at a dosing amount.

We don't do either of these things, but sometimes wonder if they would be worth investigating. 

Has anyone heard of these? Or better, do you do them?!

Many thanks for thoughts. 

P


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## randomange (Aug 20, 2010)

I think the reason they subtract the fibre from carbs in the US is because food labels in the US normally have fibre added in the total carbs value, whereas in the UK they're separate.

I don't normally bolus for protein, but I'm starting to think that I might have to when I'm having meals that have a lot of it.  I've noticed that if I have something with a lot of meat in it, I tend to end up being high a few hours later.  I haven't figured out a way to bolus for it though!  I have to add about 25% onto my bolus if I'm having something particularly fatty like pizza, so I might try something like that to start with and use an extended bolus, and see how it goes.

ETA: I've definitely heard of other people bolusing for protein, but it seems very much to be an individual thing as to whether people find they need to or not.


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## Adrienne (Aug 20, 2010)

Hi

Yes  I know a couple of people who do minus the fibre but I don't.

I also know someone who counts eggs at 6 carbs for both her boys as she proved they both needed them to be counted.

I think you need to do what works.  If you are finding you have a problem with fibre or protein then look into it.


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## Robster65 (Aug 20, 2010)

I was always taught that protein is free. ie. meat, fish, eggs.

Only ever bolus for carbs. I think my ideas may need to be brought up to date.

Is it the 21st century already ? 

Rob


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## Robster65 (Aug 20, 2010)

Could it be that the protein and fibre are delaying the absorption rate of the carbs ?

ie. they lower the GI of whatever you're eating with them, as does fat.

Rob


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## Adrienne (Aug 20, 2010)

Robster65 said:


> I was always taught that protein is free. ie. meat, fish, eggs.
> 
> Only ever bolus for carbs. I think my ideas may need to be brought up to date.
> 
> ...



No you are right totally.  However in the US they do it differently.  I don't know about what randomage said about that the US add the fibre onto the carb content on the box so can't comment on that.   I may well ask the US Children with Diabetes and see what their answer is, intriguing.

Some people do however find that some or too much protein does play havoc and do have to bolus for it occasionally.


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## HelenM (Aug 21, 2010)

In Europe fibre is already deducted from the carbs on nutritional labels. So 
25g  carbs per 100 and  5g fibre means just that. No need to deduct the fibre.
In the US the same label would say 30g carbs of which 5 g fibre so can be deducted .
This can create 2 problems.
1) if you look up carbs on an internet site and it is a US site you will have fibre included in the carb count and need to deduct it.
2) You need to read the labels of imported goods carefully since they too may  occasionally have US style labelling.

(it works the other way I remember there was a Swedish crispbread exported to the US with European labelling, some people in the US  were perplexed as how it could have 5 g of carb and 6 g of fibre; if they subtracted the fibre they had -1 carbs!)

As to protein, I've never been told to do it but I do a guestimate and bolus  for high protein meals (English breakfast/ barbecues). 
Eggs in particular I need to bolus for. I think (and its only my idea) that the protein in eggs is very easily assimilated and therefore coverts to glucose very quickly.


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## Robster65 (Aug 21, 2010)

This is all new to me regarding protein conversion. I have an inkling about nutrition and some of the processes but I've never thought to consider it othre than a modifier of the GI. And that's only been in the past few weeks !

I'm seeing a dietician in a few weeks, so I'll write it on my list. Thanks guys.

Rob


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## Patricia (Aug 21, 2010)

This is really interesting, thanks all. Sorry to post it in the wrong place at first! Shows how much a creature of habit I am...

Don't know about how things are labelled in the States -- though I should, being American. 

I'm actually now feeling quite confused, when I think about it. So the fibre issue seems really only to apply with labelling? What about in normal life, say when dosing lentils or brown bread? This leads me back to what Rob is saying, about GI... Hmm... Adrienne, if you meet with any joy on the american list, please do let us know.

Re protein: yes, we've wondered about cheese and eggs in particular. I know someone who boluses 5g for an egg, if that helps. How did you arrive at 25% for cheese randomange?

bye for now


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## Adrienne (Aug 21, 2010)

I have asked one of my American friends who knows everything


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## Adrienne (Aug 21, 2010)

Hi

Right well I've had a 'conversation' with the main man dietician at cwd for the USA.   The conversations are below.  


1.   
From: Adrienne Burton  
Sent: Saturday, August 21, 2010 7:33 AM
To: 
Subject: Hello

Wonder if you can help me.    I go on a diabetes forum in the UK and there has been a discussion about fibre and carb counting.

We are very aware that in the USA you minus the fibre from the carbs and use that number as your carb content.   We don't do that in the UK.   We are thinking that on food labels in the USA that they actually include the fibre in the total carb content so it would read something like :

Carb total  =  20
of which are sugars  =5
of which are fibres  = 5 

then you minus the 5 for the fibre so your carb would be 15.

Is this right?    

In the UK they don't add on the fibre into the total carb amount.

We are just trying to get our head around it.  


2.
From USA :
Good morning on a rainy gray day! J (we really need the rain ? haven?t had any here all week, although an hour north of me, they had two tornados yesterday!)

I am cc?ing *******  for an explanation ? he is CWD?s dietitian and will do a much better job explaining it than I can?

Children with Diabetes, Inc. www.childrenwithdiabetes.com


3.
Hello Adrienne,

With the example you cited below, you are correct in subtracting the 5 grams of fibre from the 20 grams of total carbohydrate.
According to the American Diabetes Association, you can subtract the fibre from the carbohydrate total when there are 5 grams or more of fibre per serving of food.

Please let me know if you have any further questions.

Cheers,


4.
Hi ***

Thanks for that.

Can you just clarify that in the US the fibre is included in the carb total on labels please which is why you subtract it?  If it isn't on the label then you don't subtract it?  Is that right? 

In the UK it isn't on the label so we do not subtract the fibre.   

Thanks and this is very helpful.

Adrienne


5.
Hi Adrienne,
Yes, the fibre is included in the total carb count typically on US food labels.
I?m not sure why fibre is not included on UK labels.



6.
Hi

Thanks.

Fibre is included on the label but in a different place to the carbs, its lower down the list I think so is separate from the carbs completely.   

Now I understand why you subtract the fibre.   Thank you very much.

Adrienne



Hope that helps everyone and clarifies why the American's subtract the fibre.  Makes more sense now.


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## Patricia (Aug 21, 2010)

Nothing like straight from the horse's mouth: brilliant Adrienne. It does make sense, and is what Helen and randomange were saying I think... So IN FACT it's not like Americans randomly take away fibre from a carb count -- just that fibre is usually included in the carb count, so of course it has to come off. 

Certainly something to be aware of in different foods from different places, heavens!

So while we're solving problems, anyone know of a list of places to start with carb counting proteins?!


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## Adrienne (Aug 21, 2010)

Patricia said:


> carb counting proteins?!



Love that phrase.  Now I was never any good at English but that has got to be called something as proteins are just so not carbs so how can you carb count proteins,   is that irony or something else?

hehehehehe I know what you mean though.

I think that that is up to the individual and if you find a particular protein you need to include in a carb count then go for it.  Bit like counting a fat in a sauce you add a few carbs on (well I do sometimes).

Or my friend adding on 6 carbs per egg !


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## HelenM (Aug 21, 2010)

> So while we're solving problems, anyone know of a list of places to start with carb counting proteins?!


I think it might be adding to your problems but on Tu diabetes there is a TAG  group  


> Total Available Glucose. The premise behind TAG is that a portion of the protein and fat content of the meal will also contribute to carb loading above and beyond the actual carbs in the meal."


 http://www.tudiabetes.org/group/tagers

(hope thats OK to link to another forum)


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