Fun Ways to Teach Carbohydrate Counting

AADE Program Session
Saturday August 14, 2004
2:00-3:00 pm

Reviewed by Joelle Escoffery, PhD

Medical nutrition therapy for diabetes is an important and difficult concept that requires patients to have skills, knowledge, and the ability to translate cognitive information into behavior. When teaching complex behaviors, a simple didactic approach may not be the most effective.  Instead, people with diabetes attempting to make dietary changes report that a "hands on" approach is much better. They prefer simple and practical information, they want to have the myths separated from the facts, they want to acquire skills, and they want to apply the knowledge and skills they have acquired immediately.

There are a variety of strategies that can be used to teach patients to count carbohydrates. When designing games for patients, numerous different factors must be taken into account, including age, gender, level of play, number of players. Educational objectives and game content need to be identified, and a debriefing strategy (ie, how to assess what patients have learned from the game) should be determined. The traditional way of teaching carbohydrate counting involves 3 components: identification of foods that contain carbohydrates, identifying the amount of carbohydrates in each food, and determining how much of a given carbohydrate-containing food that is needed for each meal or snack. These objectives can be used to structure games to make carbohydrate counting more engaging and informative for patients.

Once the learning objectives and content have been created, there are a variety of strategies that can be used. For example, the use of metaphors may be an effective approach. By pairing an unfamiliar concept like carbohydrate counting with a familiar concept, such as mercury in a thermometer, complex nutrition information can be simplified and made more meaningful for patients. Many variations on simple matching games can be used to teach patients how to identify foods with carbohydrates and how to determine the amount of carbohydrate in each food. Blackjack carbohydrate or The Carbohydrate Price Is Right can be used to focus on the numeric aspect of carbohydrate counting.  Patients can be given carbohydrate parameters (such as 21 g of carbohydrate in the case of blackjack carbohydrate), and their objective is to create a meal that fits within the given parameter. By using simple strategies such as these, patients can learn complex meal planning concepts in a more engaging, interactive, and meaning way.