Ok, I’ve tried Better Brand, Hero, and other breads claiming low carb counts with some claiming low “net” carbs based on fiber counts. I’ve had mixed results. Sometimes they seem to work, i.e. the lower carb count seems to work with a lower insulin dose (sometimes it works to well sending me too low); other times it clearly does not work, with the inevitable spike sending me up to 150-160-180-etc. Has anyone else tried these things? What results with which products?
(Hey, at least I’m supporting the economy trialing various products!)
Also, on the good side, I tried the refrigerated/reheated pasta after cooking and it worked (at least the first time!). I tried 50% of what I’d normally bolus for the pasta amount (I’ve never figured out if the weight is pre- or post-cook! I used post-cook weight of 4oz.) with my wife’s standard marinara sauce. My BG went down about 20-30 points within 45 mins, nosed up at about 60 mins about the same #, then settled down. I’ve got to repeat the trial for confirmation it worked out…
I’ve tried a few of the low carb breads and wraps like Mission Carb Balance . I usually count net not total for dosing. BG is great then a couple hours later I’ll see a hundred point rise with a arrow straight up. My guess is that I do digest these wheat or other indigestible starches that are in the low carb breads it just takes my stomach a couple hours. But this is just a guess and I really have no idea.
So I just have regular bread or buy the Outeraisle Cauliflower rounds at Costco. Those act like a true low carb product for me. I think the only ingredients are cheese and eggs?
Base Culture has 3 breads that actually work for me, and most other breads do not. All are in frozen section. I find mine in Wegmans and Whole Foods.
I adore their 7 Nut & Seed and their Keto bread. I also indulge in their Cinnamon Raisin keto bread. A bit higher in carbs per slice, but worth it. Delicious treat with butter, or made into french toast.
In all cases, I weigh my food. Their reported carb and protein contents are spot on. No surprises.
Last time I checked “net” carbs is meant to include all the digestible complex carbs, but the rules for US food labelling don’t allow on the digestible ones to be included in “fiber”. On the FDA food label “carbohydrates” includes utterly indigestible stuff, like the sawdust added to parmesan cheese; this is not true of EU and, maybe still, UK food labels.
There’s no breakdown that allows us to distinguish completely indigestible from digested-after-several-hours; they get lumped together with all the other digestible carbs as the difference between “total” carbohydrate and “dietary fiber” (which is not allowed to include the digestible part):
N17. Does total carbohydrate include dietary fiber?
Answer: Yes. Dietary fiber must be listed as a subcomponent under total carbohydrate. 21 CFR 101.9(c)(6)
The Nutrition Facts Label final rule defines “dietary fiber,” in relevant part, as “non-digestible soluble and insoluble carbohydrates (with 3 or more monomeric units), and lignin that are intrinsic and intact in plants; isolated or synthetic non-digestible carbohydrates (with 3 or more monomeric units) determined by FDA to have physiological effects that are beneficial to human health.”
So all the stuff on the food label that is marked as “dietary fiber” may not be digestible by a human.
So… given a US food label subtract the “dietary fiber” to get the correct carbs for insulin. The whole thing about “digestible” fiber is, at least in the US, misleading, but then so are the US food labels.
Adsorption rates vary of course by I have invariably found that foods containing complex carbs cause me to spike massively. I don’t eat the staples (wheat, oats, rice, [i.e. grains], cassava, yam, manioc, potato [tubers]) as a result. Just too much of a spike.
The delayed spike is the pizza effect; fats can slow down the adsorption of the staples and can do so quite a lot (as in pizza, fry bread). We can use this to our advantage, particularly with a pump where the appropriate basal can be delivered when the high kicks in. That’s too much work for me, I just don’t eat the stuff.
Slower adsorption carbs; digestible fiber, protein and fat, can be handled more than adequately by modern CGM/pump systems. Of course not everyone has access to those. The current advice for AndroidAPS is to underbolus for food and let the AI handle the remainder. The problem I have is that starches behave the the worst for me; give me a slice of bread and I will be as ratty as a hamster without a wheel. The (US) food label does not list the starches. Outside the US just do the “carbs” on the label, or maybe 80% as AAPS seems to currently recommend.
Thx! I love having a explanation for that whole weirdness of the hours later rise. I have always just joked that I have some sort of super amazing digestion.
@Josie Thanks for the feedback. I tried the Hero white and seeded this week, fist two experiences seemed positive, but yesterday just spiked very high (218) with the other items eaten not changing…could by YDMV…will try again this morning!
I use the Carb Balance “tortilla” things and they seem to work for things like fish tacos and the like without a significant impact, though like you I see a subsequent rise (two hours later or so), but it’s easier to compensate for.
@MsCris I hadn’t seen or heard of the Base Culture varieties, but just looked them up at our local Wegmans. A bit pricier than the Hero and Better Brand, but if they work for you, I’ll give them a try. I give credit to those like @jbowler who have “just given up” on breads, but I like a plain ham and cheese sandwich too much to give up totally; I’ve cut back, but don’t want to yield.
I just had a followup consult for my recent kidney stone surgery with the guy that apparently “wrote the book” on preventing stones. He initially wanted me to give up on salad, almonds (any almond product), salted nuts of any variety. I spoke up and said, “Doc, you realize I’m T1, had to give up most of favorite foods because of that, and now you’re knocking out the rest of things I CAN enjoy…I’ll do something’s, but I have to eat and I’m not willing to give up every food I enjoy, so you’re going to have to meet me in the middle somewhere!”
@jbowler Thanks for the great review of the food label rules/impacts. Interestingly, the first Endo I had said she’d never heard of subtracting fiber from carbs, just to count all the carbs, period. When mis-dx’d T2 the “training class” I went to said to subtract half of the fiber and half of the protein (if more than 5g). Seems to be a lack of standardization within the community (perhaps a T2 vs T1 thing?) or people relying on old training. I used the rules provided as a T2, followed the Endo advice initially as a T1, but I’ve come around over the last year to following the advice to subtract all the fiber and treating for high fat/protein meals with additional dosing over the following 5-8 hours. I’m interested in trying iAPS’s FPU algorithm. Am trying out Loop-dev’s GBAP and IRC starting this morning; will give that some time/test first for a couple of weeks, then possibly iAPS depending on Loop-dev results. Perhaps they’ll have an impact on the apparent “bread” issue…we’ll see. As with all things, make a “relatively small” change, test, and adjust from there.
I am very hesitant of “net carb” claims. There are 2 different types of fiber, soluble (digestible) and insoluble (indigestible). Most nutritional labels I’ve looked at with have “dietary fiber.” It appears that this is a combination of the 2 types of fiber. The problem, that soluble fiber is a digestible carbohydrate.
What works for me is to subtract 50% of the dietary fiber from total carbs to get something that is more realistic.
I do eat a product called Wasa Multi Grain CrispBread. It has an honest nutritional label, 1 slice has 8g total carbs, with 3g dietary fiber (1g soluble and 2g insoluble) with 0g total sugars. So the true net carbs is 6g per slice. This is the only food item I am aware of that breaks down the fiber types.
AAs to Better Brands I took a look at their label for buns. Listed dietary fiber and sugar alcohols. Sugar alcohols really mess with my gut heath, and I find that they can cause elevations in blood glucose.
If insoluble fiber is listed you are safe to subtract that from total carbs. If dietary fiber is listed subtract 50% and it may work out OK. No guarantees because the labeling is disingenuous.
The current Keto diet fad is pushing a lot of misinformation. But we who monitor our BG, food choices and insulin bolus will see the truth.
Wow, @TomH , giving up all that would be hell on me, too! Sorry you deal with kidney stones, that’s rough.
I’ve eaten Base Culture breads for four years now. Wegmans has the best prices I’ve found. I agree they’re pricey, but worth the semblance of normal eating for me!
I save the ends in a freezer bag to use as buns for burgers/sliders. Great at friends’ cookouts, etc.
I bring slices with me to restaurants to use in place of their bread, and none have ever denied me once I mention T1D.
I find they need a couple rounds of toasting to get toasty. And I toast them before making french toast, so they absorb the egg better. I also make croutons and stuffing from them. Versatile.
@CarlosLuis I 100% agree with your post, I find the same with fibers and sugar alcohols on my BG. I wish all fibers were identified as soluble or insoluble on the label.
Inulin and sunchoke are ones added to boost fiber/reduce net carbs and called keto…totally false. I spike like crazy later. I don’t know how they’re allowed to make those claims.
The keto fad stuff, with all those newer crazy ingredients I mentioned, do me in most of the time. I have to read ingredients carefully each and every time I shop - especially since manufacturers modify ingredients without notice!
I’ve found the best method for a sandwich is to have a big salad first but this would be totally off limits for you.
Have you ever tried the Ezekiel breads with a longer pre or maybe super bolus? They are a little slower absorbed and the slices are smaller. Like 12 net per.
Somewhere my wife got a figure from Berstein for the carb-equivalent of protein (it is most likely in the index entries for gluconeogenesis) that number, well, the one we currently use, is 6g of protein yields 1g of glucose, EVENTUALLY. It takes a while.
So a rule of thumb I’m migrating towards is to bolus for the fast acting carbs; glucose/fructose (fast but rate limited), sucrose (fast, no rate limit) and starches (fast, no rate limit). Then I leave the rest for AndroidAPS. The open loop Insulet (Omnipod) equivalent is an “extended bolus” and the MDI equivalent is an increased basal.
“Think like a pancreas” is completely dismissive of protein (based on the index), “Pumping Insulin” is close to what I said but still underestimating the effect for those of us on low carb (“keto”) diets.
Thanks to all for many ideas that I’ll need to try out! Apparently…there will be more math in my life as none of the various programs I’m aware of for counting carbs allow for inserting my own formula to determine the fat and protein carb impacts except for a spreadsheet of my own design!
To be clear, while the kidney doc said I needed to give up salad, nuts, etc., I’ve got to draw the line somewhere and this is it! I’ve compromised a fair degree, I’ve tried to be as “compliant” as feasible but I have to be able to eat. I’d like to like it. So I’ve drawn my “line in the sand” (that’s why its sand vice stone) and will continue with salad in moderation, nuts (albeit unsalted) in moderation, sandwich’s (albeit lower salt…who knew the salt was in there) in moderation, carbs in more “significant moderation.” But elimination of all foods I care for is NOT going to happen… How’s that song go? “what’s the living for?” (And no, that isn’t a cry for help, just my self assertion and being my own advocate!) Thanks again for all the ideas!
Hi Tom-
If you like pita bread, I have found these to be pretty good. They’re tasty and do not spike my blood sugar. I like to slice them in half for my turkey burgers or as a snack warmed up with a nut butter. They are usually found in the deli area of supermarkets - it’s the flax, oat bran & whole wheat kind as opposed to the straight up whole wheat.
Jennifer
