#1662 Bolus 4 - Tomatoes

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1662 Bolus 4 - Tomatoes (10/25/2025)

Hosts: Scott Benner (A) & Jenny Smith (B)

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Episode Overview

This episode of the Bolus 4 mini-series focuses on how to bolus insulin for tomatoes—a food often overlooked as a carbohydrate source but commonly consumed, both raw and in various dishes. Scott and Jenny dissect the considerations, share personal anecdotes, and provide practical strategies for integrating tomatoes into diabetes management using the Meal BOLT framework. The tone is conversational, accessible, and occasionally humorous.

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Key Discussion Points & Insights

Tomatoes: Fruit or Vegetable? (01:25–03:18)

• Jenny (B) quizzes Scott on tomato stats, revealing tomatoes are the second most consumed "vegetable" in the U.S. (311.5 lbs/year, including all forms).
• Discussion:
  • Tomatoes are botanically a fruit but are classified as vegetables culinarily and for trade (per an 1893 U.S. Supreme Court decision).
• Memorable Fact:

  "Tomatoes are technically a fruit, but they are very low carb and low glycemic. So they get grouped in with vegetables."
  — Jenny (02:19)

Carb Counting: How Many Carbs in Tomatoes? (03:18–04:47)

• Raw tomatoes: ~4–5g carbs per medium raw tomato.
• Grape tomatoes: ~1g carb each.
• Restaurant salads: Be cautious, as restaurant salads often have hidden carbs (15–20g or more), especially at chain restaurants.
  • Scott: "That’s the way people miss on their meals all the time. Like a little bit here, a little bit there, a little bit there..." (12:28)

Practical Bolusing Considerations: “Do Tomatoes Need a Bolus?” (05:08–06:52, 10:39–13:10)

• Low-Glycemic Index: Tomatoes digest slowly; they’re unlikely to spike blood sugar significantly.
• Situational Approach:
  • Active scenarios: If eating tomatoes during physical activity (e.g., gardening), a bolus may not be necessary.
    • Jenny: "If I'm going out for yard work, probably not, but absolutely if it's part of a meal." (06:14)
  • Meals: Incorporate the carb count into your total meal bolus—Jenny often counts ~10g for a bowl containing a medium tomato and cucumber.
• Pre-bolus?: Not usually needed due to low glycemic impact.
• Meal Context: Salad veggies (using "fist size" estimation) ~3–5g carbs.
• Insulin-to-Carb Ratio Impact: Whether missing 2–5g matters depends on your ratio; negligible for most, more important for those with high insulin sensitivity.

CGM & Tweaking: Learning As You Go (11:18–12:00)

• Testing: If unsure about the glycemic impact, check CGM 1–2 hours after eating tomatoes.
  • Jenny: "Sure. Take a peek at the one hour mark, especially if you didn't bolus for it." (11:39)
• Regular Consumption: Once confident, detailed checking isn’t necessary, but remember to include all carbs from meal additions (salad, burger toppings, ketchup).

Personal Anecdotes & Banter (06:55–10:19)

• Scott’s Aversion: Scott reveals he’s never eaten a raw tomato, which leads to playful banter:

  "I swear to God, I've never eaten a tomato in my life... It's something about the skin and the squish and the mush altogether. It's too many different."
  — Scott (06:56)

• Jenny’s Traditions: Grew up eating tomatoes straight from the garden; likes them with salt, pepper, feta, or as salsa—encourages Scott to try more.
• Texture Talk: Scott’s dislike is about the combined textures—likes grapes only if they’re cold and firm. Has never eaten salsa either!

  "I don't even know that I know what a tomato tastes like if it's not sauce or ketchup. And I also have never had salsa before in my life."
  — Scott (09:34)

• Jenny’s Response: Roasts Scott, “You're weird.” Encourages him to try salsa, suggests different meal combos.

The Meal BOLT Framework Recap (00:00–01:22, 13:19–End)

• Meal BOLT Steps:
  1. Measure the meal (carbs, protein, fat, glycemic index)
  2. Evaluate yourself (current blood sugar, IOB, activity, stress/illness)
  3. Add the base units (carbs ÷ insulin/carb ratio)
  4. Layer a correction if needed
  5. Build the bolus shape (standard vs. extended)
  6. Offset timing (consider pre-bolus or combo bolus)
  7. Look at CGM later
  8. Tweak for next time
• Scott: "We measure our meal...evaluate yourself...add the base units...layer a correction...build the bolus shape...offset the timing...look at the CGM...tweak for next time..." (13:19–13:59)
• Importantly: Although the show is conversational and informal, the hosts are following Meal BOLT principles in every food discussion.

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Notable Quotes & Moments

• On missing “small” carbs:

  "A big thick slice on a burger could be two carbs. And not that that's going to like throw the whole thing off, but when you’re swagging to begin with...now we’re seven down..."
  — Scott (12:03)

• On carb sensitivity:

  "For me, let's say my insulin to carb ratio is 1 to 20...If you're at a ratio of 1 to 4, that's a half a unit of insulin that you miss."
  — Jenny (12:38)

• On practical advice:

  "If you're trying some of these things for the first time...take a peek at the one hour mark, especially if you didn't bolus for it."
  — Jenny (11:37)

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Segment Timestamps

• 00:00–01:22 — Introduction & Meal Bolt framework explanation
• 01:25–03:18 — Tomato trivia: Fruit or vegetable?
• 03:18–04:47 — Carb counting in tomatoes and salads
• 04:47–05:58 — The hidden carbs in restaurant salads
• 05:08–06:52 — The necessity of bolusing for tomatoes
• 06:55–10:19 — Personal preferences and banter about raw tomatoes
• 10:39–13:19 — Review of bolusing/measuring logic; recap of main takeaways
• 13:19–End — Detailed description of Meal BOLT and closing remarks

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Takeaways for Listeners

• Tomatoes are low-carb and low-glycemic, making them unlikely to cause significant blood glucose spikes for most people.
• Whether you bolus for tomatoes depends on amount, context, insulin sensitivity, and activity level.
• When in doubt, factor in the carbs (especially at restaurants or in combined dishes), check your CGM after eating, and tweak your approach for next time.
• The Meal BOLT framework can help you systematically approach any food, even seemingly insignificant ones like tomatoes.

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For more on the Meal BOLT approach, visit juiceboxpodcast.com/meal-bolt.

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End of Summary

Transcript

[A]

Welcome back, friends. You are listening to the Juice Box Podcast in every episode of Bolus 4. Jenny Smith and I are going to take a few minutes to talk through how to bolus for a single item of food. Jenny and I are going to follow a little bit of a roadmap called Meal Bolt. Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM tweak for next time. Having said that, these episodes are going to be very conversational and not incredibly technical. We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of Meal Bolt in every episode, we we will be thinking about it while we're talking. If you want to learn more, go to juiceboxpodcast.com Meal Bolt. But for now, we'll find out how to bolus. For today's subject, nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan.

[B]

Is on the list. You said the top 10 is what you found.

[A]

Jenny started without me. Okay, so second on the most consumed vegetables in the US list is. Do you want to guess?

[B]

Or most consumed vegetables.

[A]

I'll give you the weight. People eat about 311 1/2 pounds of it a year, including canned versions and pureed. Huh.

[B]

I wonder if.

[A]

Is it corn and fresh salsa?

[B]

Oh, tomatoes.

[A]

Tomatoes, yes.

[B]

Did you know that tomatoes aren't really a vegetable? You know that, right?

[A]

I mean, the government doesn't seem to know it because it's on the list. I know.

[B]

Yeah, I know.

[A]

Is it a fruit? It's a fruit because it has seeds.

[B]

No, it has to do with the designation of my understanding from having looked it up is it has to do with the flower and where the edible portion develops from out of the flower.

[A]

Okay.

[B]

And so that is what designates a tomato as a fruit. It's interesting. So there you go. Tomatoes are technically a fruit, but they are very low carb and low glycemic. So they get grouped in with vegetables.

[A]

Yeah, here it is. The difference is, in botany, a fruit is the mature ovary of a flowering plant, typically containing seeds. Tomatoes form from the flowers ovary after pollination ink and contain seeds, which means they meet this definition perfectly. Just like apples, peppers, or cucumber. In culinary terms, we call tomatoes vegetables because they are used in a savory dish rather than a sweet dish. So that distinction that says is cultural, not scientific.

[B]

Huh.

[A]

Huh. In 1893, the Supreme Court ruled that tomatoes should be taxed as vegetables for trade purposes, officially classifying them as vegetables in commerce, even though botanically their fruits. Interesting. Okay, well, now, you know, you got.

[B]

A little bit of information behind how to bolus for a tomato.

[A]

Yeah. Before we get to the bolusing part, you've learned something. Look at you out there in the world learning something. But at 4 or 5 grams for a raw tomato, I mean.

[B]

Yeah. Again, this is where kind of like potatoes. It's like small, medium, large. You know, you're. I usually think of the grapey kind of tomatoes. Like, there's a little small, poppable kind of tomatoes, maybe a gram of carb a piece at the most. Honestly, they're really good in terms of nutrient quality, too. But your typical, like, sliceable tomato, probably somewhere between 5 to 10 grams, based on the size.

[A]

See, when I think about talking about this, I think about, like, a chef salad coming out that clearly has, like, a whole tomato, like, wedged up in it and split around. I don't think that's the thing people generally look at and go, oh, there's carbs there.

[B]

No.

[A]

You know, because it's a vegetable or. Or it's. You know what I mean? Like, that kind of stuff, too. Like. So I just wanted to bring it up.

[B]

No, that's a good one. Because in terms of talking about vegetables, when they're mixed up like that for a salad, really good mixed greens, lots of salad veggies, the onions, the, you know, tomatoes, the peppers. I usually use that fist kind of piece as well. A fist of raw vegetables is about three to five grams.

[A]

Okay.

[B]

And most salads from a restaurant are a pretty good 15 to 20 grams of very low glycemic carbohydrate.

[A]

Yeah.

[B]

Also that people aren't thinking of.

[A]

Restaurant salads from, like, chains have an astonishing number of carbs in them that you wouldn't expect. So it is definitely worth looking up if you're in a certain setting, because you could just think, salad, what this is 15, 20 carbs. Like, you know, and it could end up being a lot more. So.

[B]

Yeah.

[A]

Tomatoes, glycemic index, not huge.

[B]

They're not high at all. I mean, they're definitely low glycemic. If I don't even know what the glycemic index of them is, I know they're in the low category, which is under 55 is low glycemic.

[A]

Not a quick hit. Okay, so let's say you're going to sit down with that. I've seen people eat tomatoes like apples before. It is not uncommon. I'm going to sit down with my tomato. It's I don't know, 5 carbs. I've measured it out. Going to evaluate myself. I got to think if I'm a person eating a tomato raw, I'm probably a fairly healthy person with a low stable blood sugar. If I am in that situation, does it need a bolus, do you think put a five car bolus on and eat it? I mean I would always, but not if I was active. If I was out in the yard gardening and I picked up a tomato.

[B]

And ate it, you went bolus.

[A]

I don't imagine I would think that bolusing was necessary because of the activity, but if it was a sedentary thing, it might be a bolus and eat thing to me as well. I don't see a ton of need for a pre bolus there.

[B]

Right, correct. If it's something like in the summertime we always have tomatoes and cucumbers and they're really starting to ripen now in our garden. And I love tomato, cucumber, a little bit of salt and pepper and then I put some garlic in it and I put a little bit of feta cheese in it and absolutely 100% I bolus for that. Again, if I'm going out for yard work, probably not, but absolutely if it's part of a meal. My typical bowl that I eat is I've averaged it to 10 grams. That's what I give myself. This is for, you know, a medium ish size Tomato and probably a 4, 4 to 5 inch cucumber.

[A]

Yeah, I've never had a tomato in my life.

[B]

Are you kidding me?

[A]

I swear to God, I've never eaten a tomato in my life.

[B]

You've eaten sauce though, have you not?

[A]

Sure, yeah, yeah. I make sauce from fresh tomatoes. If you're talking about taking the tomato and cutting it into wedges and putting a piece of it in my mouth, it seems horrifying to me. Wow. It's something about the skin and the squish and the mush altogether. It's too many different.

[B]

So you wouldn't even eat them on a salad if they came sliced up on the salad?

[A]

No, I would give them to my, another person at the table.

[B]

That's like our neighbor we have right next door. And when we first moved in, we planted the, you know, we had loads of tomatoes and we brought them over.

[A]

He was like.

[B]

She was like, I'll take some of them because I do like tomatoes. But she's like, my husband does not. He's like. He doesn't even look to look at them. And I'm like, well, I'm so sorry that our garden faces your house and you have to look at our tomatoes, because there are a lot of them, but I won't ask you again.

[A]

Visually, I think they're very appealing. I like everything about them. You know, I guess I. Maybe I've lied to you. I have taken. What are the ones that look like plum shot? Are they plum tomatoes? Plum. What are they called?

[B]

Oh, well, yeah, they're kind of like the plum. The Roma tomato kind of idea.

[A]

I do have a recipe I like where I bake them, and I have eaten one like that. But I'm telling you. So I have. I lied, but I'm telling you. Like a raw tomato. Like, I. I imagine you've eaten a raw tomato before.

[B]

Oh, I eat like, my. I grew up with. Again, a garden.

[A]

Yes.

[B]

My dad was the one who ate tomatoes. He ate them like an apple. Along with the salt. Not salt, pepper.

[A]

Pepper.

[B]

He loved them with pepper. Right. As he ate them, he kept shaking the pepper on.

[A]

All right, well, listen.

[B]

They'Re so tasty.

[A]

All right, the next time I see one in a salad, I'll try it. Okay. I mean, I'm. I'm 54. I should probably give it a shot.

[B]

Dip it in some salad dressing.

[A]

Oh, no, that is another texture. I need to. I got to limit these textures in this thing. I like crunchy and dry. That's my vibe. Oh, yeah. I prefer crunchy dry.

[B]

So it's like the weird wet kind.

[A]

Of thing that grosses you out in along with this. It's. It's the breaking. Oh, my God. Everyone, hold on.

[B]

Skin into soft, squishy inside.

[A]

Yeah. We'll talk about the meal in a second. We'll first go through my mental illness. So there's something about the skin being crisp and breaking along with the mushy and then the fibrous. Like, it's too many different.

[B]

You don't like grapes either, do you?

[A]

Oh, I like grapes.

[B]

You're weird.

[A]

I can't explain.

[B]

Sorry. I tell you, Chris, Scott is weird. I just.

[A]

I can't explain. I need grapes to be firm, and I need them to be cold.

[B]

Okay.

[A]

All right, then I can eat a grape. They're also sweet. I would also tell you, and I'm more. I wasn't embarrassed when I started saying this, But I am now. I don't even know that I know what a tomato tastes like if it's not sauce or ketchup. And I also have never had salsa before in my life. Salsa? Yeah.

[B]

Oh, my gosh. I make. Well, I'm glad I've never sent you one of my canned salsas then, because you look at it and Ben, like, well, this was really nice. Here you go, Kelly. You can have it.

[A]

Oh, listen, salsa is consuming my house constantly. But, like. And I don't know what it is about it, if it's just I didn't grow up around it. And I associate it with being spicy. For some reason, I don't love spicy foods. So I'm sure there's mild salsa because I've seen the can at my house, so I know there is. All right, I'll try salsa, too.

[B]

For God's sake, you should try salsa if you. Yeah, actually, I really like salsa on my eggs. Saute, like eggs cooked with sauteed kale, some garlic, and then salsa on the side is, like, one of my favorite things.

[A]

I would put a little hot sauce on my eggs.

[B]

Oh, yes. Like sriracha.

[A]

Super. Yeah, No, I would do that.

[B]

Yeah.

[A]

Okay, sorry. Measure the meal. Measure the meal. And how many carbs. Elevate your. You know, evaluate yourself. Like, what are we looking at here? Is what. What's our blood sugar? Do we need a correction in there? Do the calculation, you know, you know how to do. I think we're gonna. I'm actually gonna talk it through once and probably put it in each one of these episodes. At the end of every episode, there'll be just a little, like, discussion of this. Yeah. Because when we talk about it, we don't always go all the way through it. Layer in a correction if you need it, you know, know what your correction factor is, et cetera. Then build the bolus shape. I'm guessing with a tomato, like, like you said, a little activity might eat it up. But if you're going to bolus for it, you could probably bolus and eat. Right. I don't think it's going to hit you hard.

[B]

Right. It's really not going to need your typical pre bolus consideration at all. Really Low glycemic and eaten along with other things like vegetables in a salad. Again, you may not need that.

[A]

Unlike with a potato. Do I have to look at my CGM an hour, Two hours, Two hours later? I'm not expecting to see much from this.

[B]

I think if you're trying some of these things for the first time in consideration of foods that you have in your diet, but you're not really quite sure what they're doing. Sure. Take a peek at the one hour mark, especially if you didn't bolus for it. Right. If you really don't know what a tomato is going to do, even if you're not going to be active, you're just kind of curious. Does it hit me at all? Great. Take a peek an hour or two later.

[A]

Yeah. But after, you know, you should probably know.

[B]

Correct.

[A]

And then just don't forget your. Don't forget the tomato next time you have a salad or you know, there's a big slice on a burger. I mean, I'm sure that sounds crazy to people, but a big thick slice on a burger could be two carbs. And not that that's going to like throw the whole thing off, but when you swagging to begin with and you look and you go, oh, the roll.25, but the roll is actually 30. And then you ignore the tomato and it's two, we're now seven down. And then you don't think about ketchup. Ketchup's got a lot of sugar. And now it's five, six more carbs. That's the way people miss on their meals all the time. Like a little bit here, a little bit there, a little bit there. You know what I mean?

[B]

And as we're talking about the number of grams of carb in things that sound like they're really low carb. Right. You also have to say, well, for me, let's say my insulin to carb ratio is 1 to 20. If I eat a 2 gram slice of tomato and I don't actually bolus for it, I'm not going to see a major dent in my blood sugar. I'm not going to see a problem for missing that 2 grams. If you're at a ratio of 1 to 4, that's a half a unit of insulin that you miss.

[A]

Yes. No kidding. All the time. Like I, I would say, what about the ketchup you just put on? And people, it's ketchup. And I'm like, that, some of that ketchup is crazy how much sugar it is. Right. So. All right, thank you. I appreciate you doing this.

[B]

No, this was great.

[A]

Awesome. In each episode of the Bolas 4 series, Jenny Smith and I are going to pick one food and talk through the bolusing for that food. We hope you find it valuable. Generally speaking, we're going to follow a bit of a formula. The Meal bulk formula M, E, A, L, B, O, L, T. You can learn more about it at juiceboxpodcast.com forward/meal-bolt. But here's what it is. Step one. M Measure the meal. E evaluate yourself. A add the base units. L layer A correction. B. Build the bolus shape. O, offset the timing. L. Look at the CGM&T tweak for next time. In a nutshell, we measure our meal. Total carbohydrates, protein, fat, consider the glycemic index and the glycemic load. And then we evaluate yourself. What's your current blood sugar, how much insulin's on board, and what kind of activity are you going to be involved in or not involved in? Do you have any stress hormones, illness? What's going on with you? Then A. We add the base units, your carbs divided by insulin to carb ratio. Just a simple bolus. L layer of correction, right? Do you have to add or subtract insulin based on your current blood sugar? Build the bolus shape. Are we going to give it all up front 100% for a fast digesting meal? Or is there going to be like a combo or a square wave bolus? Does it have to be extended? Extended? Offset the timing. This is about pre bolusing. Does it take a couple of minutes this meal or maybe 20 minutes? Are we going to have to Again consider combo, square wave boluses and meals, Figure out the timing of that meal and then L look at the cgm. An hour later, was there a fast spike? Three hours later, was there a delayed rise? Five hours later, is there any lingering effect from fat and protein? Tweak, tweak for next time. T. What did you eat? How much insulin and when? What did your blood sugar curve look like? What would you do next time? This is what we're going to talk about in every episode of Bolus 4. Measure the meal, evaluate yourself. Add the base units, layer A correction. Build the bolus shape, offset the timing. Look at the CGM tweak for next time. But it's not going to be that confusing and we're not going to ask you to remember all of that stuff, but that's the pathway that Jenny and I are going to use to speak about each bolus. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast. The episode you just heard was professionally edited by Wrong Way Recording wrongwayrecording Com.