Tips for Understanding the Amount of Carbohydrate on the Nutrition Facts Label and Ingredients list
About two hundred years ago, Americans ate 0.09 ounces of sugar per day. In 1970, we ate 5.4 oz of sugar per day, and today, about 6.7 oz daily, or 3 pounds or six cups of sugar per week. The United States ranks as having the highest average daily sugar consumption per person (https://www.thediabetescouncil.com/45-alarming-statistics-on-americans-sugar-consumption-and-the-effects-of-sugar-on-americans-health/; https://www.dhhs.nh.gov/dphs/nhp/documents/sugar.pdf). Sugary diets are linked to not only obesity and contributing to the current obesity epidemic, but to also increased risk of heart disease, diabetes, poor dental health, high blood pressure, and high cholesterol. Clearly, as a Nation, we need to decrease the amounts of sugars we consume. In the Unites States, our dietary food labels are regulated by the Food and Drug Administration (FDA) and United States Department of Agriculture (USDA). These regulatory bodies have made every effort to improve our food labels for clarity and accuracy over the years. And yet, there is tremendous confusion on how to interpret food labels. Here, we focus on understanding the Carbohydrate and sugars on the label, due to the negative health consequences of consuming excessive carbs; as a courtesy to the huge amount of people trying to cut back on their carb intake to follow popular low carb “keto” diets; and as a service to the diabetic community, that truly need to understand what they are consuming for the best management of their situation. Let’s dive in.
- Total Carbohydrate (TC): If you are maintaining a “Low-Carb” lifestyle, and TC is high (more than 20 grams per serving), the food could still be healthy and acceptable. How is that possible pray tell? TC also contains fiber (insoluble and soluble forms), and fibers (also known as pre-biotics) are the healthy molecules that are not-digestible by human cells, but are a great energy source for colonic microbes, and can also slow down simple carb digestion. So, the first order of business in deciphering TC is to subtract off the fiber, resulting in “Net Carbs” (NC). If the fiber content is 11 grams, NCs are 14 grams.
- Sugars: Sugars refers to the amounts of monosaccharides (glucose and fructose as examples) and disaccharides (sucrose as an example) that are determined to be present based on chemical analysis, or determined by a reference source (less accurate). A food can have small amounts of naturally occurring sugars, but most of the sugar on a label comes from “added sugars”, those sugars that are not naturally occurring in the food, ingredient, or supplement. Unless you are performing rigorous exercise, the levels of simple sugars in a food should be low (well under 10 grams per serving) because high levels of simple sugars are converted to fat and stored in our adipose tissues; can cause low energy swings; contribute to cavities; and make it more challenging to burn fats (for example as part of a “Keto” diet)…and there are many other concerns for high levels of simple sugars in our food and liquids. Simple sugars in liquids are faster absorbed and the negative consequences amplified. Despite all the hullabaloo, do not single out fructose as the culprit, look at the total Sugars content. Sugars in and of themselves are not health villains, it is the amount of sugar that matters.
- Ingredient list: The Ingredient list provides insight into sources of TC, Fiber, and Sugars. Ingredients are listed in order of abundance. If a sugar source is the first or second ingredient, the Sugars value on the Nutrition Facts Panel will be high. Manufacturers and Food Scientists have invented a plethora of different names for Sugars and Carbohydrate Sources. You do not have to understand all of these names because if the Sugars content is high, your antennas will be up and will likely return the item to the shelf. If simple sugars are low and NC are high, we need to understand more about the sources of Total Carbs.
- Starches: Dietary starches can be detrimental to health when consumed in larger amounts; and when converted to simple sugars in our bodies, raise blood sugar (in some cases, rapidly, think corn starch). Many people think of starches as healthy, and focus more on the Sugar content on the label, than the TC. Understanding starches is not simple, because the rate of generation of sugar depends on processing, storage, and source. Starches are naturally occurring (as in breakfast cereals) or added molecules consisting of long linkages of glucose simple sugar. The rate at which a starch releases simple sugars upon digestion relative to a reference is known as the Glycemic Index or GI, a high GI being detrimental (Glycemic Load-GL- is a measure of GI that also accounts for the amount of starch present). Examples of high GI starches to avoid are corn starch and the starches in white bread. Since the individual- and overall GI rating of a food or ingredient is not typically listed, one needs to memorize or carry a GI cheat card for guidance. Starches that are gelatinized tend to have higher GI, and those that are retrograded tend to have a lower GI. “Modified starches” are those which have been modified chemically to achieve a particular goal such as to slow down digestion. Just because the word “modified” appears, should not automatically be a reason to avoid the food, which may be beneficial.
- Polyols: Polyols (also known as sugar alcohols) are types of carbohydrates added to foods to provide “bulk” that upon digestion yield less calories than Sugars typically due to incomplete digestion. Examples include maltitol, sorbitol, xylitol and erythritol. In some sensitive people, polyols may cause GI discomfort, but in smaller doses, and for the masses of people, they are not a concern. A general rule is to subtract half the value in grams from the polyols from the TC to arrive at Available Carbs. Subtract all of the grams from Erythritol. From Available Carbs, subtract off Fibers to get NC. If polyols are 10 grams, substract off 5 grams from TC to get NC.
- Serving size: Now that you have utilized your linguistic prowess and mastery to successfully decipher the many synonyms for carbs, manufacturers have one last trick up their sleeve. They may set a small portion or serving size. Make sure that the suggested portion size is a realistic one for your body weight. Keep track of what you actually consumed and you will make a better choice for being on a low carb regimen. When comparing to grocery items, make sure you are comparing apples to apples, that is, you are comparing the two items at the same portion or serving size.
- Tips for speed deciphering the label. If you are trying to follow a low carb or “keto”-ish/like diet, try these basic rules: TC - fiber – ½ polyols less than 20 grams and preferentially 10 or less, consider purchasing. If Sugars are less than 10 grams, and preferentially 5 or less, consider purchasing. In the ingredient list, if the top listed ingredients are corn starch or potato starch (exceptions for special cultivars of potato that would be called out as special on the packaging), avoid purchasing. Last, use your judgement based on your typical appetite and body size, to determine if the serving size is reasonable. You may need to double the suggested serving size if you are honest with yourself, and unwilling to actually stick to the serving size on the package. If you think you will be consuming double the serving size, then all the above numbers should be halved (for example, TC - fiber – ½ polyols less than 10 grams..).