Diabetes Forecast

Read Nutrition Facts the Smart Way

By Tracey Neithercott , ,

Smart shoppers know there’s more to eating healthfully than making a grocery list and checking it twice. True, having a plan of attack can help you avoid unhealthy spur-of-the-moment purchases. But even a list won’t help you decide among three similar jars of peanut butter or dozens of loaves of whole wheat bread.

That’s where the Nutrition Facts label comes in. It lists the per-serving amounts of important nutrients in a food so you can make sure you’re getting enough of what you need and not too much of everything else. If you think reading the nutrition label is akin to understanding a foreign language, read on. We break down the facts to help you spend less time staring at supermarket shelves and more time checking items off your list.

Serving Size and Servings per Container
Zero in on these two details first, and you’ll better understand a food’s nutrition. “I have seen labels that have half a muffin as a serving size,” says Bonnie Taub-Dix, MA, RD, CDN, author of Read It Before You Eat It. Some companies get crafty with the servings per container so that a food appears lower in calories and fat at first glance. Case in point: Taub-Dix recently came across a packaged-food label advertising 42⁄3 servings per container. Manufacturers decide on serving sizes based on the amount of food the average person is expected to eat as detailed by Food and Drug Administration guidelines, though many give ballpark figures—so “about 4½ servings” instead of 42⁄3.

Beverages such as soda, iced tea, sports drinks, and juice are especially tricky because many contain more than one serving per bottle. Gatorade, for example, has 80 calories and 21 grams of carbohydrate per 12-ounce serving—but there are 2½ servings in each 30-ounce bottle. Drink the entire thing and you’ll get 200 calories and 52.5 grams of carb.

Serving size is also important when comparing two similar products. Breakfast cereals are notorious for using different measurements; some list nutrients for ½-cup servings while others measure in ¾-cup or 1-cup portions.

Putting It All Together
Sure, you probably understand that carbs are an important element of a label for people with diabetes, but what about the other nutrients? Should you pick an item with lower sodium? Or is it more important to go with a lower-fat option?

“You kind of have to pick and choose which are the most important [health] conditions for you,” says dietitian Rebecca Shenkman. “That’s where a dietitian comes in.” If you have high blood pressure but don’t need to lose weight, you may place low-sodium options above lower-calorie ones. If you’re trying to lose weight and reduce cholesterol, you may look at calories and fat before sodium and protein. One tactic: Pick three nutrients—including carb grams, of course—and focus on those.

People with certain conditions may need to balance an even greater number of nutrients. (People with kidney disease, for example, need to focus on sodium, protein, potassium, and phosphorus.)

“The word ‘balance’ is so critically important,” says dietitian Bonnie Taub-Dix. “Then if on top of that balance you have variety, you have a better chance of getting the vitamins and minerals you need.”

Percent Daily Value
The “% Daily Value” column shows the percentage of the daily recommended amount of each nutrient the food provides based on a 2,000-calorie diet. It can get confusing when you consider your own calorie needs. “For a lot of women [calorie needs] might be lower and for a lot of men they might be higher,” says Melissa Joy Dobbins, MS, RD, CDE, a dietitian and spokesperson for the Academy of Nutrition and Dietetics. “I discourage looking at the percent daily value.”

That said, the % Daily Value can be useful in determining whether a serving of a given food is high or low in a particular nutrient. Those that have less than 5 percent are low in a nutrient. “Good” sources of a desirable nutrient have daily values between 10 and 19 percent while “excellent” sources generally have 20 percent or more of a daily value.

Often vilified in the fight against excess weight, calories are an essential aspect of any diet. But most Americans get many more calories than they need—and that’s when pounds add up. Though a 2,000-calorie diet is touted as average, your needs may be higher or lower depending on your age, weight, and activity level. The best way to find out how much is too much? Talk to a dietitian or diabetes educator, who can give you an estimate of your ideal daily calorie allotment.

Calories From Fat
This number tells you how many of the food’s calories are from fat (one of the three macronutrients; carbohydrate and protein are the other two). As a general rule, no more than 35 percent of your daily calories should come from fat—but the food label shows calories, not the percentage. If number crunching isn’t your strong suit, you’re in luck: “I generally don’t find it that useful to look at calories from fat,” says Dobbins. Instead, look at the next section of the label, Total Fat.

For fast nutrition facts, use websites and smartphone
apps such as calorieking.com
on the go.

Total Fat
The overall amount of fat in a food is important to note, but taken alone it can be misleading. That’s because a high total fat content isn’t necessarily a bad thing (unless you’re trying to lose weight, in which case reducing fat is one way to avoid putting on pounds). “We’re fat phobic,” says Taub-Dix. “Fat added to a meal [may] even give you a better blood sugar level because fat slows the absorption of sugar.” What’s more, unsaturated fats are heart healthy and belong in a well-balanced diet.

When choosing between two similar items, check the breakdown of fat in order to make the best decision. Two similar products, each with 12 grams of total fat, may be very different healthwise. One may have 3 grams of saturated fat and 3 grams of trans fat (that’s half of all fat coming from unhealthy sources!) while the other may have only 1 gram of saturated fat and 0 grams of trans fat, meaning 11 grams of the total fat is beneficial to your heart.

◗ Saturated Fat: Animal products such as meat, cheese, milk, and ice cream are loaded with saturated fat, which is linked to high LDL (“bad”) cholesterol. This type of fat is best eaten in moderation, especially by people with diabetes, who are at a greater risk for heart disease. The American Diabetes Association (ADA) recommends people with diabetes eat no more than 7 percent of their total calories from saturated fat. For a 2,000-calorie daily meal plan, that’s about 15 grams of saturated fat per day.

◗ Trans Fat: Through a process called “hydrogenation,” liquid vegetable fat hardens into trans fatty acids. You’ll find trans fats in baked goods, fried foods, and other processed foods, though many manufacturers have stopped using the fat in recent years because of its link to an increased risk of cardiovascular disease. If you’re eating 2,000 calories a day, limit trans fats to no more than 2 grams daily.

Manufacturers are allowed to state a product has 0 grams of trans fat (or saturated fat) as long as it does not contain more than a half gram per serving. If you’re eating more than one serving, you may get more trans fats than you bargained for. “When you have diabetes, you need to be careful not to fall for this labeling loophole,” says Taub-Dix. To be safe, look for the words “partially hydrogenated” in the ingredients list; it can mean trans fats were used in the product.

◗ Monounsaturated and Polyunsaturated Fat: Do your body good by seeking out products high in unsaturated fats that boost heart health. Monounsaturated fats are found in avocados and vegetable oils such as olive and canola. Polyunsaturated fats, which include omega-3 fatty acids, can be found in fish, walnuts, flaxseeds, and soybean oil.

Help or Hindrance?
Supermarkets across the country are adopting labeling systems that use numerical or visual icons to rate food. Companies such as NuVal and Guiding Stars have created the labels with hopes of simplifying the Nutrition Facts panel.

Should you pay attention to your grocery store’s rating system? Not if you have diabetes. “It’s giving no indication of the amount of carbs,” says Melissa Joy Dobbins, MS, RD, CDE. “It can be misleading and it’s not geared enough for people with diabetes.”

Not only that, but things can get confusing for people who shop at more than one store. Your local grocery may use NuVal’s system, rating food on a scale of 1 to 100, while another store may use the star icons from Guiding Stars. And because each uses its own formula to determine a food’s value, you may find the same food rated differently at each place.

That’s not to say you must ignore the ratings—just be sure to use your brain, too. “It’s really a nice, easy way to navigate the store,” Shenkman says. “But you still have to use your own skills and smarts to make sure you’re not overdoing it on the carbs.”
NuVal scores foods from 1 to 100—the higher, the more nutritious.

Just because a product contains unsaturated fat doesn’t mean you’ll see it on the package. “There’s no labeling rule on the mono- and polyunsaturated fats,” says Rebecca Shenkman, MPH, RD, LDN, a dietitian with Bryn Mawr (Pa.) Hospital. Some manufacturers choose to add it to the label, but many products simply list saturated and trans fats. Subtract saturated and trans fat grams from Total Fat to see how much is healthful fat.

In an ideal world, everyone would study all aspects of a nutrition label before deciding on a product. In the real world, there are too many nutrients to balance to give equal attention to all. That’s why dietitians give many clients the OK to skip over the cholesterol number. Though cholesterol in food can raise your body’s cholesterol level, it’s not the most likely culprit. “It’s really the [trans and] saturated fat in our diet that forces the liver to produce more cholesterol,” says Dobbins.

That said, if you have very high cholesterol or if your doctor or dietitian believes it’s a smart idea to focus on this aspect of a food label, know that 200 mg per day is a good maximum. And limit high-cholesterol foods, such as shrimp and eggs.

Salt (a mixture of sodium and chloride) makes foods tasty, but it affects the body in a less than savory way. Too much sodium can lead to high blood pressure. The ADA recommends people with diabetes get no more than 2,300 mg per day, an amount most Americans exceed regularly. To rein in the amount of salt you eat, limit the number of sodium-heavy foods, such as soup, bread, deli meat, and cheese. Salt even sneaks into sugary foods (one Oreo-flavored Jell-O pudding cup, for instance, has 230 mg of sodium), poultry (in the form of salty solutions used to plump the raw meat), and seafood (frozen shrimp are treated with chemicals that contain sodium).

Though it’s not required on a label, some manufacturers choose to list the potassium content of a food. The nutrient plays an important role in your health: Studies have shown that a high-potassium diet can negate the blood pressure–raising effects of too much sodium. The Institute of Medicine recommends getting 4,700 mg of potassium daily. Good sources include yogurt, potatoes, winter squash, avocado, halibut, pistachios, and bananas. Pay especially close attention to potassium if you have kidney disease; when the kidneys stop working, too much of the nutrient can build up in the blood and result in an abnormal heart rhythm, which can be life threatening.

Total Carbohydrate
For people with diabetes, the total carbohydrate, fiber, and sugar listings have the most relevance when it comes to blood glucose control. Though the total number of carbohydrate grams in a given food is important to note, it’s more meaningful when considered alongside the grams of fiber and sugar in a food.

◗ Dietary Fiber: Fiber is an important part of any meal plan, helping to lower cholesterol and keeping you full longer. Good sources of fiber have between 2 and 5 grams per serving. High-fiber foods have more than that. Fruits, vegetables, and whole grains are all smart picks when it comes to fiber content. Aim for 25 to 30 grams daily.

For foods without packages (such as produce, seafood, or bins of loose grains), you can find nutrition information on a nearby sign. If you can’t find a nutrition label for one of these foods, talk to your store manager.

But there’s another reason people with diabetes will want to pick foods high in this nutrient: “[Most] fiber doesn’t break down into the blood sugar,” says Dobbins. “It goes through the body undigested.” What that means for you: Though it’s a carbohydrate, fiber won’t raise your blood glucose the way sugar will. So a product with 12 grams of carbohydrate and including 5 grams of fiber is likely to raise your blood glucose less than a similar product with 12 grams of carbohydrate and no fiber.

◗ Sugar: For people managing blood glucose levels, it’s tempting to focus solely on a product’s sugar content without paying attention to the total carbohydrate. That’s a problem because it’s the total carbohydrate grams, not just the sugar grams, that affect blood glucose levels. 

A downside to the nutrition label is that the entry for sugar doesn’t specify type. So a handful of candy may have the same number of grams of sugar as a cup of milk, but the sugar in the milk is naturally occurring (as are the sugars found in fruit) and can fit into a healthy meal plan. When it comes to diabetes, both natural and added sugar will raise blood glucose—the goal is to eat more of the nutritious foods with natural sugars and fewer “empty” calories from added sugars. “It’s not as simple as looking at sugar,” says Taub-Dix. “You need to head on down to the ingredients list. You need to look out for words that indicate [added] sugar, even if it’s not spelled S-U-G-A-R.” Look for items such as high-fructose corn syrup, sucrose, dextrose, evaporated cane juice, and fruit juice concentrate.

◗ Sugar Alcohols: If you eat a lot of sugar-free food, you may have noticed an entry for sugar alcohols. You can spot sugar alcohols in the ingredients by looking for words ending in “tol,” such as erythritol, malitol, sorbitol, and xylitol. These chemicals sweeten with fewer calories and less of an effect on blood glucose. (The downside? Sugar alcohols may have a laxative effect in some people.)

◗ Other Carbohydrates: You won’t always find this label on a food’s Nutrition Facts panel, but some manufacturers add it to indicate the carbohydrates that don’t come from fiber or sugar. “Other carbohydrates” are starches that are part of a food’s total carbohydrate content.

Ask your grocery store manager if there’s a registered dietitian on staff. Some supermarkets hire dietitians to help shoppers make smart food choices and understand nutrition labels.

Proteins are the building blocks of the body and are found, for example, in meat, seafood, eggs, beans, and tofu. Though most people are at no risk of getting too little protein, it’s a good point to note on the label for its ability to keep you feeling full. Many high-protein foods are loaded with saturated fat, so choose wisely, opting for lean cuts of meat and low-fat dairy.

Vitamins and Minerals
Regardless of the product, all labels list two vitamins and two minerals that are essential for all Americans: vitamins C and A, calcium, and iron. Some products—such as cereals—may list dozens of vitamins and minerals. Though people deficient in specific vitamins or minerals may want to pay close attention to this section of the label, most people can skip it.

The Nutrition Facts are hardly comprehensive, so sometimes shoppers need to browse the ingredients list for additional details. If you’re curious about the type of sweetener in a product or whether it’s made with whole grains, this section of the label can help. Ingredients are ordered by prominence based on the weight of the total amount of an ingredient used in the product. This can give you a clue as to how much of an ingredient is in a product—those listed at the end may only be used in small quantities. Your top picks for grain-based products should list “whole grain” as the first ingredient, for example. The ingredient list is also useful for people with food allergies or who are looking for an artificial sweetener.

Comparison Tips
 Start with the serving size. Account for serving-size differences—say, by doubling everything for a ½-cup serving size in order to compare with a similar product with 1-cup portions. We did the math. Special K’s box notes a 1-cup serving size, while the other two cereals list ¾-cup servings on the box.
Kellogg's Special KGeneral Mills TotalKellogg's Frosted Flakes
(1-cup portion)(1-cup portion)(1-cup portion)


Carb23 grams
Carb30 grams
Carb36 grams
Sugar4 grams
Sugar7 grams
Sugar15 grams
0 grams
4 grams
1–2 grams
6 grams
3 grams
1 gram
220 mg
187 mg
186 mg
Fewest calories/no fiber
Highest in fiber/more carbs than Special K
Lowest in sodium/highest in carbs


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