Monday, May 19, 2014

Part 2: Too Low Carb, Not So Smart?

How did you do on the carbohydrate quiz? (Scroll down to yesterday’s post to see what I’m talking about.)   Here are my answers, and as you may have guessed, there are very few absolute true or absolute false answers in science as in life. There is always wiggle room.

1. Low carbohydrate eating will help you lose weight. T or F
                  Answer: False.  Why is it false? Because it depends on how much carbohydrate foods you ate to start with. If you always have dessert with meals, and serve bread with all your meals, and drink lots of juice and regular pop, yes, you will lose weight if you cut down on some of these foods. But, if you substitute fatty foods for carbohydrate (snacking on nuts, seeds, spoons of peanut butter instead of carbohydrate), you probably won’t do well with weight loss.

2. Low carbohydrate eating will help your blood sugar. T or F
                  Answer: False.  Again, it depends on what you used to eat or drink.  Sure, if you cut down on heavy carbohydrate foods, your blood sugar could improve, but blood sugar isn’t all about food.  Part of the problem with diabetes is that your liver may think you are starving, and will create sugar for you.  Some people get very upset when they “cut out all the carbohydrate” and their blood sugar is still well over 150 (normal fasting blood sugar is 70-100 milligrams per deciliter in the US). 

3. Everyone needs carbohydrate. T or F
                  Answer: True.  Carbohydrate is the fuel that your brain and muscles use for energy. If you cut your carbohydrate too low, what happens? Your body shifts into using fat for energy, plus breaks down protein (muscle) for sugar. That is an expensive way to eat, and your brain and muscles do not do as well with these “alternate” fuels. Headache, fuzzy thinking and weakness are possible results. And don’t forget, your heart is a very important muscle that you don’t want to weaken.

4. How much carbohydrate (in grams) is a minimum needed for adults?
                  According to the National Academy of Sciences, and adult needs 130 grams of carbohydrate per day to run your brain and muscles.  Some people with high energy needs may need a higher minimum. 

5. Athletes do better on a high-carbohydrate diet. T or F
                  Answer: True.  In fact, if athletes do not get enough carbohydrate, they will not be their best competitive self.  If you are figuring numbers, someone who is a serious athlete should be getting at least 50 percent of their calories from carbohydrate, and 60 percent is even better.
                  A few years back, one of my patients was training for the River Bank Run, and could not run more than 5 miles in training without running out of energy. It turned out he was eating just 90 grams of carbohydrate a day in an effort to lose 10 pounds.  I advised him that he should be eating at least 225 grams of carbohydrate (and more would have been better) while training, in order to keep his muscles fueled.  He was still stuck on the idea that he needed low carbohydrate, so I’m not sure how his training or his run went. (And hello? If you are training for a big run, your 10 pounds will likely “fall” off without performing any dietary tricks).

6. You need extra carbohydrate after exercise. T or F
                  Answer: True. There is a one hour window of opportunity after a big work out, where your muscles replace their glycogen (stored carbohydrate) to provide muscle fuel for tomorrow.  Take advantage of those bananas, bagels, yogurt and other goodies after a sponsored run or walk, or if you are on your own, eat some carbohydrate! Regular milk and chocolate milk are also good carbohydrate choices.

7. Carbohydrate helps you think. T or F
                  Answer: True.  See number 3 above.  Have you ever had a delayed meal and you started to get fuzzy-headed? Or a headache?  Eating carbohydrate helps both conditions, especially if the cause was a skipped meal.

8. The carbohydrate in white rice and white bread is worse for you than the carbohydrate in brown rice and grainy bread. T or F
                  Answer: False.  While it’s true that grainy foods have the added bonus of fiber and some B vitamins, carbohydrate is carbohydrate.  When someone has diabetes, it is the amount of carbohydrate foods eaten, not the type of carbohydrate foods that makes the difference.  I have talked to many people who have substituted whole grain pasta and brown rice in their meals because it is “healthier”, but they have not cut portions, and wonder why their blood sugar has not improved.

9. It is better to divide your carbohydrate intake throughout the day (rather than eat it all at one time). T or F
                  Answer: True.  Your brain and muscles appreciate a constant source of fuel, not one big smorgasbord once per day. Having trouble with energy levels? Keep the carbohydrate divided through the day. Even athletes do better with multiple meals through the day.

10. Natural carbs (such as honey, pure maple syrup, fruit, and 100 percent fruit juice) don’t count toward your carbohydrate for the day. T or F
                  Answer: False.  All the examples above are “natural” sugars and carbs, but they are still carbohydrate, and are not “freebies”.  And some of them add up very fast in calories as well.

So how did you do? 

If  you’d like to argue any of these points with me, come see me at diabetes class and we’ll talk.

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