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Diabetes Update: Available and Unavailable Carbohydrates

Number 6; February 15, 2001

By David Mendosa

This mailing list keeps you up-to-date with new articles, columns, and Web pages that I have written. I list and link most of these on my Diabetes Directory at

From time to time this mailing list may also include links to other Web pages of special interest.

My most recent contributions are:

    on February 15, 2001
  • The Invisible Web is now on the American Diabetes Association's Web site at Databases, which comprise the overwhelming proportion of information on the Web, are invisible to the spiders and crawlers that find the Web pages that search engines index. In this column I share my favorite medical databases. These include the American Medical Association's massive directory of essentially all the country's M.D.'s (where you can search for a nearby endocrinologist) and the U.S. Department of Agriculture's nutrient database (where you can search for calories, carbohydrates, and other nutrients in more than 6,200 foods).

Updates include:

  • Available and Unavailable Carbohydrates
    The concept that certain carbohydrates are unavailable because our bodies do not utilize and metabolize them is an important one generally and specifically for understanding the glycemic index. I mention it on my Glycemic Index page at in the section "What about Portion Size? And how is GI Determined?"

    The information there is correct. But in some e-mail messages that I have written in the past few years I oversimplified the issue because my understanding was incomplete.

    Unavailable carbohydrates are what we call fiber. In the United States fiber is included in carbohydrates, so a determination of the amount of available carbohydrate requires that we subtract out the fiber. The problem is that in some other parts of the world fiber is not included in carbohydrates. This can lead to incorrect assumptions about certain imported foods.

    The clearest explanation comes from a report by the "FAO/WHO Expert Consultation on Carbohydrates in Human Nutrition at In an obscure footnote to a table on page 43 the report says:

    Most countries in Africa, Asia, and North America calculate carbohydrate 'by difference'. Most countries in Europe and Oceania analyse carbohydrate directly. Values for Europe and Oceania therefore do not contain unavailable carbohydrate, while values for Africa, Asia and North America do. Method of deriving carbohydrate is rarely given.

    This affects two crispbreads recommended by Dr. Richard K. Bernstein in his book Dr. Bernstein's Diabetes Solution on page 135. Each 9 gram slice of GG Scandinavian Bran Crispbread (from Norway) has, according to its label, 5 grams of carbohydrates and four grams of fiber. In some correspondence I had incorrectly subtracted the fiber to get a figure for available carbohydrates. Likewise, 8 hard breads (15 grams) of Bran-a-Crisp (also from Norway), according to the label, have 6 grams of carbohydrates and 6 grams of fiber.

    The real problem with both these crispbreads, as Dr. Bernstein admits, is that they taste like cardboard. Much more tasty, to my palate, are low fat/low carb tortillas made by La Tortilla Factory in Santa Rosa, California. For example, each large tortilla has 21 grams of carbohydrate of which 15 grams are fiber for a net of 6 grams of available carbohydrate. The URL is

  • Dale Evans
    My article, "Catching Up With Dale Evans," appeared in the March 2000 issue of Diabetes Forecast, pages 76-78. It is also on-line here at The singer-actress who teamed with husband Roy Rogers in popular Westerns and wrote the perennial song "Happy Trails To You" had type 2 diabetes and died February 7 of congestive heart failure at her home in Apple Valley, California. She was 88. Dale Evans was among the most famous people I ever interviewed and certainly one of the nicest.

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