Not all Carbs are Created Equal

Pasta and Carbs

In a packed grocery store, it can be incredibly challenging to decipher the countless food labels in order to find the choice thar best suits our health goals. For those of us seeking to improve our metabolic health, reduce the risk of developing diabetes, or decrease the likelihood of diabetes-related complications, monitoring our carbohydrate intake is important.  When we read a nutrition label, the number next to “carbohydrate” is the summation of all of the carbohydrates combined. However, not all forms of carbohydrate are processed the same way by the body. This means that the number listed next to “carbohydrate” on a nutrition label does not necessarily correspond with the degree to which it will increase our blood sugar. This makes deciphering a nutrition label unnecessarily confusing. This article will help to demystify the carbohydrate section of a nutrition label by explaining how the types of carbohydrate differ. We will also explain how to navigate different food choices to select the carbohydrates that suit your needs.

Total Carbohydrates

total carbohydrates

All nutrition labels are required to report the quantity of major macronutrients (fat, protein, carbohydrates). The bolded line “total carbohydrates” is a summation of all of the different types of carbohydrates in the food combined. Most people who are monitoring their carbohydrate intake look only at this bolded line in order to make a judgement as to whether a food is “good” or “bad” for them. Unfortunately, this number is misleading and can lead to us classifying a food as “unhealthy” when it actually is beneficial to blood sugar control. The indented subcategories of “fiber” and “sugars” listed below “total carbohydrates” helps to paint a more accurate picture of the healthiness of a food.


fiber does not raise blood sugar like simple carbs

Fiber is a type of carbohydrate that is incredibly healthy. Fiber can help us to feel full, lower cholesterol (which reduces the risk of heart disease), and improve digestion. In addition, fiber is not processed by the digestive tract in the same way as simple carbohydrates. Simple carbohydrates are quickly broken down, enter the bloodstream, and increase blood sugar levels. Fiber, on the other hand, is not able to be digested by our gut. So, instead of breaking down into simple glucose molecules, fiber passes directly through our digestive system. It does not spike our blood sugar and it does not require insulin to be digested. This makes fiber a metabolically healthy carbohydrate.    

There are two types of fiber, soluble and insoluble. Soluble fiber is the type that dissolves in water to form a gel-like material. It has been shown to help lower cholesterol and reduce appetite and improve insulin sensitivity.  While there are no dietary reference intake guidelines for how much soluble fiber we should consume, many experts recommend eating eight grams of soluble fiber each day. Oatmeal, apples, beans, citrus, carrots, and barley are all great ways to add soluble fiber to your diet. 

Insoluble fiber helps to keep you regular. It does not dissolve in water and passes through the stomach intact. It has been shown to improve insulin sensitivity, which is extremely beneficial for individuals who are pre-diabetic or have type 2 diabetes. Whole wheat flour, bran, seeds, and the skins of multiple fruits and vegetables are high in insoluble fiber.

When we read a nutrition label the subcategory of “fiber” includes both soluble and insoluble fiber. In order to have a food claim that it is a “good source of fiber” it needs to contain 2.5 g of fiber per serving. A food that touts itself as an “excellent source of fiber” needs to have 5 g of fiber per serving.  On a daily basis, the Dietary Guidelines for Americans recommend consuming 14 g of fiber per 1,000 calories.

As a word to the wise for those of us who plan to add heaps of fiber to our next grocery list, ease into it. Since fiber cleans out our digestive tract, it can take a little getting used to. Too sudden of an increase can lead to gas, bloating and constipation. Gradually increase your fiber intake and be sure to drink plenty of water.


sugar intake and total carbohydrates

The next subcategory under “total carbohydrates” is sugar. Sugars are not inherently bad. However, they can be detrimental to our health when consumed in large quantities. The line item on a nutrition label “total sugars” includes the amount of sugar that is naturally present in a food as well as the added sugar.  There are naturally occurring sugars in milk and fruit, both of which are part of a healthy, balanced diet.

Added sugars are included during the processing of foods. Added sugars is a number on the nutrition label that we want to pay careful attention to limit. They are heavily present in cakes, cookies, and sodas, causing a rapid increase in blood sugar. This can lead us down a glucose rollercoaster full of cravings, weight gain, inflammation, and poor metabolic health.  These types of sugar are commonly listed on ingredient labels as: dextrose, sucrose, fructose, table sugar, and corn syrup. Added sugars can also include sugars from syrups, honey, concentrated fruit juice, or vegetable juice.

Sugar Alcohols 

what are sugar alcohols

Sugar alcohols are a type of carbohydrate that are commonly used in place of sugar. They are sweeteners with half the calories of regular sugar. While they are present in many fruits and vegetables, some sugar-alcohols are man-made (from sugars and starch) and added to processed foods. Since they are incompletely absorbed from the small intestine, they act as a low-calorie sweetener that does not impact blood sugar levels to the same extent as simple carbohydrates. However, since they are not fully absorbed, a high amount of sugar alcohols can cause gas, bloating or diarrhea in some individuals.

What to Look for in a Nutrition Label 

how to read nutrition labels

Now that we have broken down the carbohydrates that are listed on a nutrition label, let’s talk about how this helps our food choices. If we are looking to improve metabolic health and control our blood sugar, then we are likely keeping an eye on the carbohydrate section of a food label. However, not all carbohydrates spike blood sugar. In order to differentiate these types of carbs, let us shift our focus a bit to net carbs. While “net carbs” is not an official term used by the FDA, it can appear on labels from time to time. Net carbs is a measure of the amount of carbohydrates that you can digest (aka the amount of carbs that have potential to significantly increase blood sugar). To calculate net carbs you take the total carbohydrates and subtract the fiber and sugar alcohols. What we have left is the amount of carbohydrates that should be counted toward your daily total. For example, look at the photo on the right.  The label on the left is from organic flax seed crackers. The total carbohydrate content per serving is 10 g. However, there is a whopping 9 g of dietary fiber. This leaves only 1 g of net carbohydrates for every serving; snack away on these healthy crackers. The label on the right, however, is for Ritz crackers.  They have the same amount of total carbohydrates per serving as the previous crackers, but zero fiber. That leaves a full 10 g of net carbohydrates per serving, meaning that the Ritz crackers are not the best option for individuals who are monitoring their blood sugar.

If calculating the net carbs sounds like a hassle, the start by prioritizing foods that are higher in fiber and lower in added sugars. This will help in selecting foods that contain the healthy fiber we need for digestion, weight management, and cholesterol, while reducing the amount of unhealthy and processed sugars.


Author: Dr. Colleen Gulick