This Diabetic information section has been made possible thanks to the efforts and great work of Rabbi Hirsch Meisels of Jewish Friends With Diabetes International. We thank him for allowing us to reprint sections of his diabetic information booklet. His work has proved pivotal for those diabetics who require to be extremely rigid in the amount of matzah and wine which they consume.
Nous avons pu créer cette section informative pour les personnes diabétiques grâce aux efforts et au travail fantastique du Rabbin Hirsch Meisels de Jewish Friends With Diabetes International. Nous le remercions de nous avoir permis d’utiliser et d’imprimer des extraits de sa brochure d’information sur le diabète. Son travail s’est avéré un outil essentiel pour ceux qui sont atteint du diabète et qui doivent être extrêmement rigides par rapport aux quantités de matsa et de vin qu’ils consomment
The K’zaisim (minimum required amount) for Matzah:
It is necessary for us to know how much matzah constitutes a k’zayis on Pesach, so that we can perform the following mitzvohs: Moitzi Matzah, Korech, Afikomen, Bentching.
Introduction: We have spent many long days on researching the correct shiur of a k’zayis. The work was particularly difficult because all the Shiurim are originally given in volume and we had to convert the amounts to weight, so that they could be used practically. (The only way the original measurements could be used is by crushing the Matzah and measuring its volume.) The weight measurements are especially useful, as we will need to know the matzah’s weight anyways in order to calculate the amount of carbs it has (more on that later). This explains why we state the weight amounts in grams, and not in ounces; we count carbs in terms of grams. Acquiring the shiur in measurements of weight wasn’t an easy job, as we found different opinions regarding the formula for converting cc (a measure of volume) to grams (the measure by weight). We therefore used the most stringent shiur, taken from the sefer “Middos Vshiuri Torah”, which the author figured himself using special tools. Although certain factors, such as the wetness of the matzah, might influence its weight (If a matzah is baked for a few seconds more, it will weigh less.) the formula we used covers that margin too. When you follow our shiurim, you might eat more than needed, rather than less. [Other sources that were used for the Shiurim are “Piskei Tshuvos” from Rabbi Simchah Benzion Rabinovitz shlit”a, “The laws of Pesach” from Rabbi Blumenkrantz shlit”a, “Seder H’oroch”, and “Halachas of K’Zayis” from Rabbi Yisroel Pinchos Bodner shlit”a. Rabbi Bodner also shared his vast knowledge with us over the phone.] In addition to the precise shiur by weight, we have included each shiur in comparison to a whole matzah (i.e. third matzah, quarter matzah, etc.). You may notice that it is almost impossible to be exact using this method of measurement, but we’ve included it to give you an approximate idea of the size and shape of the portion under discussion. Machine matzahs are generally uniform in size and thickness. Therefore, one shiur can be given which will be good for all machine matzahs. However, handmade matzahs, commonly referred to as shmurah matzahs, can vary significantly in weight, size and thickness. For this reason, it is impossible to assign a precise shiur as a standard k’zayis for all hand-made matzahs. One can, however, get a close approximation of the shiur needed, by weighing the matzahs. Typically, thin matzahs weigh 51 grams; medium-sized matzahs weigh 58 grams; and thick matzahs weigh 72 grams. [Usually, one would get nine thin matzahs to a pound, 7 ½ medium matzahs to a pound, and 6 thick matzahs to a pound.] The carb amounts we’ve used were supplied by the Manischewitz matzah manufacturing company.
Serving size: 1 Matzah (32 grams)
Total carbohydrate: 27 grams
Dietary Fiber: 1 gram
Based on the above information, matzah has a carb factor of 81%, or 0.81. (For instructions on using carb factors, refer to our Tu B’shevat article.) According to the matzah bakeries, the nutrition facts would be the same for shmourah matzah and for machine matzah. Although the amount of wetness in hand-made matzahs can vary, there is no way to have a more exact figure. Some matzah bakeries claim that their matzahs have more bran than others, which increases fiber content and reduces the effective carb content. However, we have not been able to get any nutritional data on that. (If you do use these matzahs, you may be advised to underestimate their carb content slightly.)
[Note: In previous articles, we stated that matzah has a carb factor of 70%. This was based on the nutrition facts of chametz’dige matzah. The carb factor for pesach matzah is 81%.]
To Keep in Mind
In the Poskim, we find that people who are sick (cholah) can use the smaller shiurim. A diabetic is not a sick person, but if one controls his/her carbohydrate intake due to a health reason such as diabetes, especially if his/her preferred option of treatment is a reduced carbohydrate diet, he/she would be permitted to use the smaller shiurim. (Of course, discuss this with your Rav who understands diabetes.)
The Zohar Hakodosh states that matzah is “Meichlah D’asvasah” (a food that heals). People mistakenly assume that eating matzah can’t cause harm because it is a healing food. However, we know that an overdose of medication may be very harmful, and the same is true with matzah. It will heal when consumed according to the correct dosage, but not when overdosed. The Nodah B’Yehudah, who originated the most stringent shiurim, states that in the case where his new, larger shiur would result in a leniency, the smaller shiur should be used. It is also well known that although the Brisker Rav zt”l was very stringent in all halachic matters, he was unusually lenient about the halachos of fasting on Yom Kippur. He explained that by being lenient with a mitzvah due to health reasons, he was indeed being stringent with the mitzvah of “vchai bahem” (and you shall live in them). The same could be true here: if one would act stringent and use larger shiurim at the risk of neglecting his personal health, it would be considered a leniency in the all-important mitzvah of “v’chai bahem”. Even the Nodah B’Yehudah did not approve use of the bigger shiurim where it would result in a leniency, as would be the case here. It is also remarkable to note that the Chazan Ish, who is famous for advocating the largest shiurim, actually used the smaller shiur (17 grams of matzah) for himself.
The various shiurim: There are differing opinions about the correct measurement of a k’zayis. The Shulchan Oruch rules that a k’zayis is half of an egg, while the Rambam holds that the proper measurement is a third of an egg. There is further debate on exactly what amount constitutes the halachic measurement of an egg. The Chazon Ish held that an egg is 100 cc. Most follow this opinion once a year, for the first k’zayis of matzah on Pesach. The opinion of the Grach Naah is that an egg measures 57.6 cc, and the sefer “Halachos of K’zayis” uses the measurement of 55 cc for an egg.
We can sum up these opinions into three separate shiurim, all of which will be used in this article. They are:
1) A k’zayis is half of an egg, or 50 cc. [Chazon Ish zt”l] 2) A k’zayis is half of an egg, or 28.8 cc. [Grach Naah] 3) A k’zayis is a third of an egg (with the egg measuring 55 cc), or 18.3 cc. [Rambam]
[We have converted these shiurim to amounts in weight by using the formula of 100:55 meaning that 100 cc equals 55 weight grams.]
Please note that there are smaller shiurim that we have not included in this article. If one needs to restrict carbs even further, the issue should be discussed with a Rav (and you can also give us a call for some more ideas).
Which one of the Shiurim should be used?
Moitzi Matzah: The mitzvah to eat a k’zayis of matzah on the first night of Pesach is a d’oraysa (Torah commandment). Therefore, we are required to use a shiur that conforms to even the most stringent methods of calculating a k’zayis, so as to be sure of fulfilling the mitzvah. The first shiur mentioned above, that of the Chazon Ish, is the most stringent, and therefore the preferred measurement for motzi matzah on the first night of Pesach.
This shiur (27.5 grams) contains 22.3 grams of carbohydrate. (27.5 X 0.81 = 22.3)
Use the following guidelines:
The Shulchan Aruch states that initially (if it is not too difficult) one should eat two k’zaysim; one k’zayis from the top matzah of the ka’arah, and one k’zayis from the broken middle matzah. The poskim rule that this largest shiur (50 cc/ 27.5 g.) is technically twice as large as the smallest shiur of k’zayis (18.3 cc/ 10 g.). Therefore, by taking half of this shiur from the top matzah and half of this shiur from the middle matzah, one will satisfy the Shulchan Aruch’s requirement of taking two k’zaysim. (Although the two pieces would only add up to one k’zayis of the largest shiur, it would be two k’zaysim of the smallest shiur, and that is sufficient.) For more opinions on this issue refer to “Piskei Tshuvohs”, page 262. For example, if one uses thin matzahs, he would need a bit more than one half of a matzah for the largest shiur. He should break off a quarter of the top matzah and another piece that size from the middle matzah. By taking from both matzahs, he has fulfilled his midirabonon requirement to take a k’zayis from each matzah. By eating a total of a half matzah he has fulfilled the Torah requirement of eating a k’zayis matzah.
Some poskim specifically caution that one should not eat more matzah than required for Moitzi Matzah, because it is preferred to swallow the whole k’zayis at once. Also, if one overeats by Motzi Matzah, then his eating of the afikoman would constitute an achilah gasah (overstuffing).
Korech: The mitzvah to eat korech (a k’zayis of marror sandwiched between a k’zayis of the bottom matzah) is midirabonon. We may, therefore, use the second, more lenient shiur of 16 grams.
This shiur (16 grams) contains 13 grams of carbohydrate. (16 X 0.81 = 13) Use the following guidelines:
If one has difficulty with eating matzah, he may use the third, smaller shiur of 10 grams.
This shiur (10 grams) contains 8 grams of carbohydrate. (10 X 0.81= 8)
Use the following guidelines:
The mitzvah to eat afikoman is midirabonon. The poskim state that preferably, it is better to eat two k’zaysim of matzah for afikoman (one k’zayis to commemorate the korban Pesach and one k’zayis to commemorate the matzah eaten with it). For these two k’zaysim, it is sufficient to use the smallest shiur of 10 grams, or a total of 20 grams of matzah. This shiur (10 g. X 2= 20 g.) contains 16 grams of carbohydrate. (20 X 0.81 = 16)
Use the following guidelines:
If it is difficult to eat two k’zaysim, one can fulfill the mitzvah by eating one k’zayis of the middle shiur, or 16 grams of matzah. (This is the preferred shiur for korech and for bentching. See table above.) If even this is difficult (e.g. he is ill), one may eat one k’zayis of
the smallest shiur of 10 grams. (The same as the smaller shiur for korech. See table above.) Some Poiskim note that one should add 2-3 grams to every shiur to compensate for the little matzah that is left between the teeth.
The shiur needed for bentching is 16 grams of matzah. (The same as the preferred shiur for
korech. See table above.) This amount would be used throughout Pesach whenever one
washes and bentches.
Please note: This article is meant only as a reference, and not to give any Psak Halacha. All issues should be discussed with your Rav or Posek.
The four cups:
The shiur for the four cups is a reviyis. Rabbi Weismandl shlit”a wrote to us that one should use a cup that holds the amount of the largest shiur of 5.1 oz. (150 ml), but he need only drink according to the smallest shiur of 2.9 oz. (86 ml). Since one is only required to drink roiv reviyis (the greater part of the reviyis), the total amount consumed would be 1.5 oz. (45 ml). Most Seder cups hold far more than the largest shiur. Make sure to buy a cup that is not too big.
[There are small measuring cups available, which measure up to 60 ml in 5 ml increments. These may come in very handy.] Grape juice is high in carbs, and a very fast acting sugar (high on the glycemic index). Being stringent by using large shiurim and drinking the entire cup would result in unpredictable blood sugars. We have therefore researched the exact shiurim needed to fulfill the mitzvah of the four cups. If wine is preferred, one may use the larger shiurim and consume the entire cup. (Refer to the section “Type of Wine”.)
For the last cup: If one wants to make a brachah acharonah (blessing after eating or drinking), one should drink an entire reviyis of 2.9 oz. (86 ml) of wine. Otherwise, one should not make the brachah acharonah.
Mixing Wine & Water
The topic of adding water to wine or grape juice is a complicated one. We have read that in the case of a wine that has no water or concentrate added by the manufacturer, one could add 60% water. However, many rabbanim have told us that one can never add more than 49% water, as one has to make sure that the taste of the wine remains. (Depending on their taste and strength, individual wines would differ in this respect.) We contacted Rabbi Yosef Moshe Greenwald (the Rav of Tzelim), who gives the hashgacha on the Kedem wines, and Mr. Michael Herzog of Kedem. By combining their halachic and professional backgrounds, they came up with the following guideline: a wine with a strong flavor can be mixed with 1/3 water, while all others can be mixed with only ¼ water.
The following list was discussed with Mr. Herzog:
These can have 1/3 water added. All cream wines that contain 12% alcohol can be mixed with only 25% water. Other creams with not more than 15% water. The dark grape juices can be mixed with 1/3 water, and this includes Concord, Concord Blush and the Sparkling series of grape juices. The white grape juice can only be mixed with 25% water. Adding water to the low carb Concord Grape juice is problematic, but in extreme circumstances a maximum of 10% can be added. If you will be using a wine that is not specified above, please discuss it with a Rav. There is an easy way to do this, without bothering to measure in middle of the Seder. For wines that can be mixed with 1/3 water, simply pour two cups of wine into an empty bottle, and then add one cup of water. For those wines to which one can add only ¼ water, pour three cups of wine into the bottle, and add one cup of water. (The size of the cup you use for this purpose does not matter. Just make sure that you use the same cup for the water and the wine.) If one follows these guidelines correctly, he will consume just 5.0 – 5.6 oz. of wine (or grape juice) throughout the entire Seder.
The following chart shows how much wine is consumed when diluted with 1/3 water. We have also included a column that lists the amount of carbs consumed when red grape juice is used (as this can be mixed with 1/3 water). The carbs in the example are based on Kedem’s Red Concord grape juice, which has 18.5 grams of carbs in a serving size of 4 oz. (In other words, there are 4.6 grams of carbs per oz.)
**The chart uses Kedem’s Gold grape juice (which can only be mixed with 1/4 water), which has 14 grams of carbs in a serving size of 4 oz. (In other words, there are 3.5 grams of carbs per oz.) A tip to help you recognize how much 1.5 oz. is: Before Yom Tov, fill your Seder cup with water, and pour .5 oz. into a measuring cup. See how full your Seder cup looks, and train your eye to recognize it.
Type of wine:
The best option would be a dry wine, which has almost no carbs. [Most dry wines contain approximately 4 grams of carbs per 8 oz cup.] If the sour taste bothers you, try to add some artificial sweetener. Liquid sweeteners are available with certifications for Pesach, or you can use saccharin tablets, dissolved in water. Because the law does not require manufacturers to print nutrition facts on wine bottles, it is often hard to know exactly how many carbs a glass of wine contains. If you prefer a wine that is carb free, you can use a glucose meter to test a sample. (We tried it with a Glucometer Elite). Test a sample of the wine just as you would test a drop of blood on your meter. If the wine you are testing is not completely carb-free, your meter will give you a HI reading. If it is a real dry, low-carb wine, the meter will read “LO”. Any other numbers you get are only a reference, as numbers that would be considered high for blood sugars are not high for wine. For example, if the meter reads 225 the wine is still relatively low in carbs. (Remember that a cup of regular soda contains 4,500 mg/dl of sugar, so keep those numbers in proper perspective.) Here are some examples of wines we tested for sugar/carb content on a glucose meter ٭
Chardonnay = 225
٭ Cabernet Sauvignon = 87 (a red wine)
٭ Sauvignon Blanc = 27 (a white wine)
These are only examples. Remember to test the specific wines that you are planning to use.
Because alcohol may drop your blood sugar, discuss with your doctor if you should take insulin to cover the carbs in the wine.
►There is more of a chance that wine will cause a low blood sugar on an empty stomach. If you do drink wine for the first cup, make sure to follow the shiurim detailed above. Or, use grape juice for the first cup.
►If you drink grape juice, please note: the carbohydrate contents of the different grape juices are not identical, and they may even vary from year to year. The carbs may range from 27 to 37 grams per cup. Please make sure to check the label.
►Type 2 diabetics should discuss with their doctors if it is better to drink wine rather than grape juice. Although the juice has a higher sugar content, many of the type 2 medications are not compatible with alcohol. It might therefore seem that grape juice would be preferable, but maybe we
can assume that drinking just the required amounts of wine for the two Seder nights will not cause any harm.
The information presented here is not meant as a definitive halachic guide. As usual, each individual should ask his own Rav what to do
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