If you are following a dietary protocol that requires counting carbohydrates (and you should be!), your first question probably is, Should I count total carbs or net carbs? And what is the difference?

In the United States, properly labeled packaged food shows Total Carbohydrates as a main category with possible sub-categories of Dietary Fiber, Sugar, and Sugar Alcohols. “For nutrition labeling in the EU and Mexico, carbohydrate is defined as ‘available carbohydrate,’ which does not include the fiber component.”1 What does all that even mean?!?

How to Read Nutrition Information on a Label

  • Fats – Total fats. The following are types of fats:
    • Saturated fats – No distinction is made between healthy saturated fats and unhealthy saturated fats
    • Trans fats – All trans fats are unhealthy!
  • Carbohydrates – In the United States, this means TOTAL carbohydrates. The following are types of carbohydrates:
    • Dietary Fiber – Typically, this means indigestible fiber. May be subtracted from total carbohydrates to calculate net carbs.
    • Sugar – Typically, refers to added sugar. For a diabetic, this number is meaningless, since all digestible carbohydrates convert to glucose in the digestion process, beginning with saliva in the mouth. Do NOT subtract Sugar from total Carbohydrates.
    • Sugar Alcohols – Artificial sweeteners. Also may be subtracted from total carbohydrates to calculate net carbs.
  • Protein – Your body needs essential amino acids for cell growth and repair.

What are carbohydrates?

Carbohydrates include sugars, starches, and soluble and insoluble fiber.2 Dr. Eric Westman of Duke University uses total carbs in his diabetes clinic; and in a one-minute video, Dr. Westman answers one of the most commonly asked questions: “What’s the difference between total carbs and net carbs?” One reason for using total carbs is that some people do absorb the fiber carbs so that the net carbs calculated may underestimate the effects of the carbs on their metabolism.3

Should we count total carbs or net carbs?

The ADA bases the recommendation for daily carbs on net carbs, which is total carbs minus fiber carbs and sugar alcohols.

Some diabetes coaches recommend a compromise by subtracting fiber carbs only when eating a whole food and the fiber carbs are part of the whole food, and they calculate total carbs for any processed food (packaged in a box, bag, jar, or can). Often the food manufacturer adds fiber carbs to the food (exogenesis carbs) and the fiber carbs are not part of the actual food. We can’t always trust the food manufacturer to be honest about the fiber carb content. “The commonly held advice to subtract ‘fiber’ from the total amount of carbohydrate on the label to arrive at ‘net carbs’ can lead to an [underestimate] of nutrient intake, as well as possibly an [underestimate] of the effect of the food on blood glucose and insulin release when those foods are processed into other foods by grinding and/or heating.”4

Franziska Spritzler lists what some sources recommend for counting carbs: 5

  • Subtract all fiber from total grams of carbs (Joslin Diabetes Center)
  • Subtract only insoluble fiber (if known) from total grams of carbs (American Diabetes Association)
  • Subtract half of the grams of fiber if the total fiber content is greater than 5 grams (Dr. Richard K. Bernstein and the American Diabetes Association)
  • Don’t subtract any of the fiber (original Atkins diet, which is more for weight loss than blood sugar control)

Michaella Thornton of Diabetes Daily says, “Counting ‘net carbs’ may work for some people, but it is not a way of counting carbs certified diabetes educators (CDEs) or other health professionals are likely to endorse nor a legal term but rather a food-industry marketing phrase.”6

One author and health podcaster recommends counting total carbs no matter what! In a podcast, he reveals the origin of the net carb calculations.7 What follows is the complete transcript of the podcast on September 9, 2017:

“I often see debate online over this idea of counting net carbs vs. total carbohydrates when on a low-carb/ketogenic diet. But do you know where the net carb concept actually came from? Most people don’t and I didn’t either until I shared a stage with Dr. Michael Eades of PROTEIN POWER fame in Cape Town, South Africa, in 2015 where this low-carb stalwart issued a public mea culpa for what he described as his ‘ding’ on the keto community.
“His original intent was for subtracting fiber from real foods like raspberries to allow greater flexibility in food choices as well as making better food quality picks for low-carbers. But what it turned into was a marketing opportunity for companies to push junk food under the guise of it being lower carb. Whether it’s net carbs, ‘effective’ carbs, or however else they try to push it on the public, the only way to be intellectually honest about your own personal carb tolerance level is to count all carbohydrates.
“If you can have more, it just means your carb tolerance is higher. Congratulations and celebrate that! And yes, I’m well aware fiber doesn’t raise blood sugar and insulin levels as quickly as other carbohydrates, but here’s the thing—there’s still a response in your blood sugar and insulin levels even if it’s not as big. So let’s not pretend it was the net carbs that got you the results in your approach. Your body was simply able to handle those carbs efficiently.
“But the flip side of that is people with insulin resistance (and that’s most people these days) who think they’re eating low-carb because they’re ‘only’ having 30g net carbs when the actual carb count is 50g total carbs. And then they blame the diet for not working when they were just overloading their body with too many carbs. This is why I encourage people to actually test for nutritional ketosis and blood sugar so you know what those carbs are doing in your body, not some net carbs math game that will lead to frustration and failure in the end.
“Kudos to Dr. Michael Eades for recognizing the mistake he made with all the honorable motivation for helping people be more savvy in their low-carb lifestyle. Unfortunately, this Pandora’s Box is so wide open it’s never getting shut again. But now that you know the genesis of the whole net carbs scam, you can completely avoid it moving forward.”

If you ever pick up a packaged food and see the label touting “Net Carbs” on it, put it back on the shelf and go to the produce section to find a real, whole food instead!

Finally, here’s a book by Dr. Eric Westman, with Amy Berger, a Certified Nutrition Specialist, that is hot off the press! It’s End Your Carb Confusion: A Simple Guide to Customize Your Carb Intake for Optimal Health. Amazon says, “Find the level of carbohydrate intake that’s right for you now, and then learn how to switch gears to a higher- or lower-carb diet when the time is right. Dr. Westman gives you the information you need to reclaim your health today—no complicated and confusing scientific gobbledygook*, only exactly what you need to understand how you got to where you are (hint—it’s not your fault!) and, more important, how to get to where you want to be.”8 [*language that is meaningless or is made unintelligible by excessive use of abstruse technical terms; nonsense]

Frequently Asked Questions

Q: I’m trying to figure out the carbs and sugars but I don’t know how many of each to consume so I feel like I don’t know anything.

A: Carbohydrates and sugar are not two different things. Sugar is a carbohydrate; so therefore, if you’re counting carbs, you don’t need to count sugar as a separate thing, because sugar IS a carb.

Q: Should we count total carbs or net carbs? And can we subtract fiber and sugar alcohols from total carbs to get net carbs?

A: From a podcast (September 9, 2017).

“I often see debate online over this idea of counting net carbs vs. total carbohydrates when on a low-carb/ketogenic diet. But do you know where the net carb concept actually came from? Most people don’t and I didn’t either until I shared a stage with Dr. Michael Eades of PROTEIN POWER fame in Cape Town, South Africa in 2015 where this low-carb stalwart issued a public mea culpa for what he described as his ‘ding’ on the keto community.

“His original intent was for subtracting fiber from real foods like raspberries to allow greater flexibility in foods choices as well as making better food quality picks for low-carbers. But what it turned into was a marketing opportunity for companies to push junk food under the guise of it being lower carb. Whether it’s net carbs, effective carbs, or however else they try to push it on the public, the only way to be intellectually honest about your own personal carb tolerance level is to count ALL carbohydrates.

“If you can have more, it just means your carb tolerance is higher. Congratulations and celebrate that! And yes, I’m well aware fiber doesn’t raise blood sugar and insulin levels as quickly as other carbohydrates, but here’s the thing–there’s still a response in your blood sugar and insulin levels even if it’s not as big. So let’s not pretend it was the net carbs that got you the results in your approach. Your body was simply able to handle those carbs efficiently.

“But the flip side of that is people with insulin resistance (and that’s MOST people these days) who think they’re eating low-carb because they’re ONLY having 30g net carbs when the actually carb count is 50g total carbs. And then they blame the diet for not working when they were just overloading their body with too many carbs. This is why I encourage people to actually test for nutritional ketosis and blood sugar so you know what those carbs are doing in YOUR body, not some net carbs math game that will lead to frustration and failure in the end.

“Kudos to Dr. Michael Eades for recognizing the mistake he made with all the honorable motivation for helping people be more savvy in their low-carb lifestyle. Unfortunately, this Pandora’s Box is so wide open it’s never getting shut again. But now that you know the genesis of the whole net carbs scam, you can completely avoid it moving forward.”

If you ever pick up a packaged food and see the label touting “Net Carbs” on it, put it back on the shelf and go to the produce section to find a real, whole food instead!

Finally, here’s a book by Dr. Eric Westman, with Amy Berger, a Certified Nutrition Specialist, that is hot off the press! It’s End Your Carb Confusion: A Simple Guide to Customize Your Carb Intake for Optimal Health. Amazon says, “Find the level of carbohydrate intake that’s right for you now, and then learn how to switch gears to a higher- or lower-carb diet when the time is right. Dr. Westman gives you the information you need to reclaim your health today—no complicated and confusing scientific gobbledygook*, only exactly what you need to understand how you got to where you are (hint—it’s not your fault!) and, more important, how to get to where you want to be.”8 [*language that is meaningless or is made unintelligible by excessive use of abstruse technical terms; nonsense]

Endnotes

1“How Carbs Are Calculated in Different Countries,” ESHA Research (July 16, 2015). https://esha.com/how-carbs-are-calculated-in-different-countries/ (accessed on 7/30/2020).

2Martin, Laura J., reviewed by. “What are carbohydrates (carbs)?” WebMD (June 26, 2016). https://www.webmd.com/diabetes/qa/what-are-carbohydrates-carbs (accessed on 7/30/2020)

3Westman, Dr. Eric C. “The Difference Between Total and Net Carbs,” [1:18] YouTube, uploaded by  Adapt Your Life  (November 19, 2015). https://youtu.be/0GaOmu8qI7Q (accessed on 7/30/2020).

4Kiddie, Joy, MSC, RD. “The Problem with Counting Net Carbs,” The Low Carb Healthy Fat Dietitian (May 31, 2019). https://www.lchf-rd.com/2019/05/31/the-problem-with-net-carbs/ (accessed on 7/30/2020).

5Spritzler, Franziska, RD, CDE. “Counting Carbs: Total vs. Net?” Low Carb Dietitian (January 21, 2013). http://www.lowcarbdietitian.com/blog/counting-carbs-total-vs-net (accessed on 7/30/2020).

6Thornton, Michaella; medically reviewed by Elizabeth Tomez, MSH, FNP-BC. “What Are ‘Net Carbs’ and Why Do They Matter?” Diabetes Daily (April 15, 2019). https://www.diabetesdaily.com/learn-about-diabetes/diet-and-fitness/understanding-dietary-macronutrients/carbohydrates-diabetes-key-facts-to-understand/what-are-net-carbs-and-why-do-they-matter/ (accessed on 7/30/2020).

7Moore, Jimmy. “Dr. Michael Eades Apologizes for the Net Carb Scam,” Livin’ La Vida Low-Carb (September 9, 2017). https://www.facebook.com/watch/?v=10155919473201320 (accessed on 7/30/2020).

8Westman, Dr. Eric with Amy Berger, a Certified Nutrition Specialist. End Your Carb Confusion: A Simple Guide to Customize Your Carb Intake for Optimal Health. Las Vegas: Victory Belt Publishing (December 15, 2020). https://smile.amazon.com/End-Your-Carb-Confusion-Customize/dp/1628604298/

FAQs 1 with Dr. Westman: The Difference Between Total and Net Carbs [1:18]

Additional References

Practical approaches to accurate carbohydrate gram counting
https://www.diabetesdaily.com/blog/carb-count-like-a-pro-305355/

Counting Carbs: Total vs. Net?
1/21/2013
http://www.lowcarbdietitian.com/blog/counting-carbs-total-vs-net>

The Problem with Counting Net Carbs
The commonly held advice is to subtract “fiber” from the total amount of carbohydrate on the label to arrive at “net carbs” can lead to an underestimation of nutrient intake, as well as possibly an underestimation of the effect of the food on blood glucose and insulin release when those foods are processed into other foods by grinding and/or heating.
https://www.lchf-rd.com/2019/05/31/the-problem-with-net-carbs/

Carbohydrates
http://www.diagnosisdiet.com/food/carbohydrates/