Consistent or Controlled Carbohydrate (CCHO) Diet for Diabetes

Diabetes is a metabolic disease that requires multiple treatment approaches. Maintaining good blood sugar control is the ultimate priority for people with type 1 and type 2 diabetes.

Most treatments are aimed at that goal, whether they’re insulin, other injections, or oral medications, along with changes to diet and physical activity.

One dietary approach for people with diabetes allows for greater diet control without a strict or burdensome plan.

The consistent (or controlled) carbohydrate diet (CCHO diet) helps people with diabetes keep their carb consumption at a steady level, through every meal and snack. This prevents blood sugar spikes or falls.

If you have diabetes or care for someone who does, keep reading to find out why the CCHO diet works so well, and how you can implement it into your daily routine. We’ll also provide sample menu plans for inspiration.

How the CCHO diet works

Your body uses carbohydrates from foods for energy. Simple carbs, like pasta and sugar, deliver quick and almost immediate energy. Complex carbs, like whole grains, beans, and vegetables, break down more slowly. Complex carbs don’t cause the sudden spike associated with the “sugar high” of a cookie or slice of cake.

Some people with diabetes take the low-carb approach and strictly limit carb intake. The ketogenic diet, for example, has been shown to dramatically improve blood sugar levels and weight in people with diabetes. But this ultra-low-carb approach only allows 20 to 50 grams of carbohydrates in a day. That may be too strict for most people.

But too many carbs can be a bad thing, too. Carbohydrates increase insulin levels and raise blood sugars. The challenge is balancing carbohydrate intake with medications and exercise to keep blood sugars in a safe range.

Leveling carb intake prevents insulin spikes and dips

The idea behind the CCHO diet is to monitor and program your carbohydrate consumption so you have fewer spikes or dips. In other words, the CCHO diet keeps your carbohydrate intake the same throughout the day, and every day of the week.

Taking medications at the same times each day and exercising at a regular time can help keep things running smoothly.

Replacing carb counting with ‘choices’

Instead of counting carbs, the CCHO diet assigns units of measurements called “choices” to foods. About 15 grams of carbohydrates equals one carb “choice.”

For example, a half cup of rice has about 22 grams of carbohydrates. That would equal 1 1/2 carb “choices” in your daily total. One slice of bread has 12 to 15 grams of carbs, so it would equal one “choice.”

Planning out your menu and limiting your total number of carb choices at a meal helps keep your carb intake and blood sugars more level.

Ultimately, the CCHO diet may be easier than tracking the number of foods from food groups or counting individual carbs to adjust your insulin accordingly at each meal.

Once you know many of the most common exchanges, you can sail through ordering at restaurants or planning your menu for the week as long as portion sizes are consistent.

What’s the right carbohydrate number for you?

An ideal carbohydrate goal or “choice” number is not one-size-fits-all. Your healthcare provider can work with you to establish a goal that makes sense for your:

• health
• weight
• level of activity
• average blood sugar numbers

Your doctor may refer you to a registered dietitian or diabetes educator. These providers can help you craft menus that fall within your choice numbers while also meeting your personalized tastes and preferences.

Choosing carbohydrates

Carbs come in three forms: sugars, starches, and dietary fiber. Though you may think of carbs simply as pasta and rice, carbs are also present in dairy, fruit, fruit juices, starchy vegetables, and whole grains.

Carbs with little nutritional value, like white rice and sugary candy, might not be great for a healthy diet. But the carbs in plant foods come packaged with necessary vitamins and minerals. Plus, these foods are some of the best sources of fiber, a nutrient that helps keep your digestive system running smoothly.

The easiest way to know how many carbohydrates are in a food is to look at the nutrition label. Of course, not all foods have a label. In those cases, you can use smartphone apps and websites like MyFitnessPal or books like the American Diabetes Association’s Complete Guide to Carb Counting.

The U.S. Department of Agriculture also maintains a Food Composition Database that is searchable. You can use both generic foods and specific brand names.

Adding a nutritionist to your diabetes management team

A dietitian or nutritionist is an expert who has been trained to care for people with specific dietary needs or concerns.

The American Diabetes Association recommends people with diabetes work with these providers. You can work together with them and your entire healthcare team to determine carb goals, monitor blood sugar levels, and adjust as needed to get the right carb number for you.

Sample CCHO menus

Here are some sample menus, including choice counts, to provide inspiration for your daily food choices. You can mix and match so you have something new each day, or you can streamline the process by eating the same foods every day.

Beware of boredom and burnout, though, which can lead to unhealthy binges. You can substitute foods with similar carb content to keep it interesting.

Day 1 CCHO sample menu

Breakfast: 1 cup oatmeal (2 choices); 1 slice thin whole-wheat toast (1 choice) with 2 tablespoons peanut butter (0 choice); coffee (0 choice); unsweetened half-and-half creamer (0 choice)

Morning snack: fresh orange (1 choice); unsweetened iced or hot tea (0 choice)

Lunch: 1/2 chicken breast (0 choice); 1/2 cooked wheat berries (1 choice); three cups spinach (0 choice); 1 cup strawberry halves (1 choice); 1 ounce toasted walnuts (0 choice); balsamic vinaigrette (0 choice); 1 dinner roll (1 choice); unsweetened iced tea (0 choice)

Afternoon snack: 4 cups air-popped popcorn (1 choice)

Dinner: salmon fillet (0 choice), 1/2 cup mashed sweet potatoes (1 choice), 1 cup steamed broccoli (0 choice); 1 dinner roll (1 choice); water (0 choice); 1 cup raspberries (1 choice)

Day 2 CCHO sample menu

Breakfast: 2 over-medium eggs (0 choice); 1 slice thin whole-wheat toast (1 choice); 1 tablespoon fruit preservers (1 choice); 1/2 banana (1 choice); coffee (0 choice); unsweetened half-and-half creamer (0 choice)

Morning snack: 1 small pear (1 choice); 1 ounce of cheese (0 choice)

Lunch: 1 cup chicken salad (0 choice); 6 crackers (1 choice); 1/2 cup grapes (1 choice); water (0 choice)

Afternoon snack: 3/4 ounce pretzels (1 choice); low-fat mozzarella cheese stick (0 choice)

Dinner: 1/2 cup cooked black beans (1 choice); 1/2 cup brown rice (1 choice); 1/2 cup corn kernels (1 choice); 1/2 cup cooked ground beef (0 choice); shredded lettuce (0 choice); shredded cheese (0 choice); 1/4 cup fresh salsa (0 choice); dollop of sour cream (0 choice); unsweetened iced tea (0 choice)

Day 3 CCHO sample menu

Breakfast: low-fat vanilla Greek yogurt (1 choice); 3/4 cup fresh blueberries (1 choice); 1/2 cup fresh orange juice (1 choice)

Morning snack: 1/2 cup applesauce (1 choice); 1 cup milk (1 choice)

Lunch: 2 slices thin whole-wheat toast (2 choices); 3 ounces sliced turkey breast (0 choice); 1 tablespoon mayonnaise (0 choice); 1 slice tomato (0 choice); 1 cup carrot sticks (1 choice); water (0 choice)

Afternoon snack: hard-boiled egg (0 choice); small apple (1 choice)

Dinner: 1 cup beef-and-bean chili (2 choices); dinner roll (1 choice); 1 small apple (1 choice); green salad, tomatoes, and cucumbers with vinaigrette dressing (0 choice)

Takeaway

A well-balanced diet, like the CCHO diet, is a healthy way to manage your blood sugar levels and weight. It may even help you lower your risk of complications from diabetes, like heart disease, stroke, and nerve damage.

Once you learn how to count carb choices, you’ll quickly put together tasty options for every meal and snack.

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