Low Carb - No Carb?
Bonnie Brown, RD, MPH, CDE
Registered Dietitian and Certified Diabetes Educator at Augusta Health
There are few food-related words that bring up a more negative connotation than carbohydrate: they make you fat, cause diabetes, make us want to eat more, more, more – they may even be causing the current world wide economic angst. Perhaps the bad wrap on carbohydrates stems from a decades long history of low carbohydrate diets espousing eating as little of the so-called poison as possible as the key to slimness and health. There also seems to be an association of carbohydrates with the not-so-healthy sources such as white bread, Twinkies and French fries. However, I would like to present a case for the healthfulness of carbohydrates and not unfairly lump them all together as equal. But since carbohydrate is such a cumbersome word, for purposes for this article I would like to shorten it to the much simpler four-letter word, carb.
It is fair to say carbs are necessary. They are abundant in lots of foods and 3 out of the 5 food groups, namely grains, fruits and milk. Needless to say there are lots of important things our bodies need in these foods. Grains have B-vitamins, iron, and if unrefined, insoluble fiber – ideal for digestion and satiety. Fruit has soluble fiber (good for the heart) and many vitamins and antioxidants. Milk is a great source of calcium and protein. Candy, desserts and soda do not constitute a food group (although some may make a case for chocolate) but are considered discretionary calories - a fancy term for junk food. These foods add calories but little if any health benefit. Carbohydrates also provide quick-burning fuel our body can safely use. So a lack of them can cause sluggishness. It is true we can burn a steak for fuel but the by-products, ketones, are tough on our kidneys. And there is little fiber in a steak. And we all know fiber is good – Mom said so, therefore it is true.
So if carbs arebeneficial, how much is ideal? The Institute of Medicine (IOM) of the National Academy of Sciences has established ranges for the percentage of calories in the diet that should come from carbohydrate, protein and fat – the three main nutrients which provide calories. For carbs the recommended range is between 45-65% of total daily calories. For a moderately active 30 year old man needing 2,600 calories a day this equates to 293-423 g of carbs. For a 65 year old sedentary female the range is 158-228g per day.
This may sound like a huge amount of carbs! But even modest portions add up quickly. A small bowl of a high fiber cereal, milk and fruit is 60-75g. A baseball-size portion of spaghetti and meat sauce and a salad provides 60g. Splitting carbs into three meals and 1-3 snacks per day is ideal for appetite control. And for people with diabetes or prediabetes blood glucose levels will also benefit.
For weight loss, some men would find 60g or carbs in three meals and 15-45g for snacks appropriate. For woman 45g may be effective for healthy, sustainable weight loss. Keep in mind though, when it comes to carbs, there is no one-size-fits-all. Needs vary based on physical activity, variations in metabolism and glucose tolerance. For people with diabetes or prediabetes tolerable amounts may vary greatly and needs to be fine tuned with activity and possible medications. The IOM recommend not restricting carbohydrates to less than 130 g per day – a very low amount for many. Any less would be potentially dangerous since the brain, in order to function, needs the ready-supply of glucose provided by carbs. And “good” carbs, such as whole grains, dried beans fruits and low fat dairy are important for reducing the risk of chronic diseases.
So maybe the four letter word really needs to not be carbs. Maybe it should be SIZE, as in portionsize. Retraining our eyes and stomachs to the 1970’s version of a muffin or bagel is not easy. But then –easy is also a four letter word.
Bonnie Brown, RD, MPH, CDE is a Registered Dietitian and Certified Diabetes Educator with Augusta Health’s ADA Certified Diabetes and Nutrition Education Program. For more information on diet, weight control or diabetes please contact them at 213-2537.