[buddy7]

So much been said on the forum about carbohydrates, I get a little confused with the varied methods, on how carbohydrates are being used with our daily diets.

To understand the condition diabetes I need to know more about what role carbohydrates plays to make a good choice diet.

Can someone explain some of the science behind these healthy foods and explodes
some of the negative myths that have surfaced in recent years about carbohydrates being bad for you, things I need to know!

The importance of carbohydrates!

What happens if we don’t get enough carbohydrates?

How do we get carbohydrates from our diet?

How much carbohydrates should we eat?

Aren’t carbohydrates fattening?

What does the glycaemic index of carbohydrates means?

Can low carbohydrates diet really help with weight-loss?

Studies have shown using carbohydrates counting as a method of managing your diabetes, which require discipline practice and a great knowledge about diabetes. In the past I found the forum a great source for information, I dear not embarked on such a quest, with-out knowing, some of the facts and answers.
Your profound knowledge will be appreciated. Thank you

[fgummett]

You don't ask much do you I suggest you read Gary Taubes' "Good Calories, Bad Calories" AKA "The Diet Delusion" in the UK. I also recommend following the links John (xMenace) has in his sig for Micheal Pollan and find out about whole foods.

I'll take a stab at answering some of this. Although I suspect you may get different opinions from others here on DF, I will try to limit myself to known scientific fact. I make no apologies for keeping the science simple...

Everything that we eat can be classified as one of three types of macro-nutrients:
Fats, Proteins and Carbohydrates.

Carbohydrates are chains of sugars - some more complex than others - but nearly all break down to sugar when digested. Some break down as soon as they hit the saliva in the mouth, while - at the other extreme - there is fibre/cellulose, which the human digestive system is unable to break down.

Fats are digested into their basic building blocks; Fatty Acids, and Protein into Amino Acids.

The body uses these basic building blocks to manufacture what it needs... insulin for example, is a protein constructed from Amino Acids.

Some Fatty Acids and Amino Acids are "essential" which means that the body cannot manufacture them and can only get them from eating Fat and Protein.

So far as we know, there are no "essential" sugars that must be ingested. Glucose for example, can be made by the Liver from Amino Acids in a process called Gluconeogenesis.

While Glucose and Ketone bodies (from Fatty Acids) can be burned by most of the cells of the body as energy, the brain is only able to use Glucose.

Glucose is often referred to as the "preferred" fuel, but my understanding is more along the lines of; Glucose provides the quick-burst "on-demand" energy after which the ketones kick in for the "long-haul".

Sounds simple enough so far..? Except that they discovered that in addition to these "macro" nutrients we also need "micro" nutrients... first the Vitamins came along, then Phyto-chemicals, anti-oxidants etc... with new ones of these being found every other day. On one hand this has led to a huge industry providing supplements, but I agree with Michael Pollan that what we really need is the "whole" package of "real" food. Bear in mind also that no natural food is simply one thing... steak for example is mainly protein and fat but is also very rich in all kinds of micro-nutrients (do a search at the USDA nutrient database).


Back to Carbs...
It is Carbohydrates that mainly drive our need for insulin.

As we all know, insulin is required so that the Glucose can pass into cells to be used as energy.

Insulin also regulates the conversion of sugars into fatty acids/Triglycerides for storage in adipose/fat cells... high levels of insulin will quickly mop up any blood glucose and lock it away as fat (for use later... in theory). High levels of insulin prevent fat from being released from the fat cells to be used as energy. It can be argued that high-levels of insulin perform this role so efficiently that it can leave the body starved of ready energy and explains the phenomenon of someone eating a large high-carb meal but still being hungry immediately after. High levels of insulin over time can also lead to Insulin Resistance and ultimately Pancreatic burn-out. Hence the argument that eating carbs is largely responsible for the downward spiral that develops into Type 2 D.

In short "Carbs + Insulin = Fat"

So, if we turn that around and minimise our carbs we also minimise our need for insulin - a basal amount is still required for daily function, and remember that Protein can be made into Glucose - lower insulin levels will allow fat to come out of the fat cells to be used as energy and yes this does lead to weight loss and improved BG levels - without the spikes driven by eating carbs.

[BlueSky]

The logic is pretty straight forward. You don't need to delve too deeply into the science. As a diabetic, you want to achieve good blood sugar control, so that you can lead a long and happy life. To achieve good control, you need to avoid foods that increase blood sugar. Carbohydrates increase blood sugar. So it is in your interests to avoid them.

It is ironic that about 70% of carbohydrate eaten is stored as fat anyway. The problem is that it pushes blood sugar right up before this happens, and this is what causes all the problems with diabetic complications. If, on the other hand, you eat fat instead, it gets stored as fat without affecting blood sugar at all.

So the question is, why eat carbohydrate in the first place? The body produces as much glucose as it needs without relying on the consumption of carbohydrate.

[buddy7]

Frank my thanks to you and BlueSky for your immediate response to my threads, sorry for my long winded questionnaire on the subject carbohydrates.

I've taken all your comments on board, and propose to used them usefully, thanks for the tip on the book, will be ordering, ASAP, will be looking in, on John's link, this evening.

What an education from you Frank, with further studies it will probably take me a little time to fathom out all your comments, but be assured, I'll get there eventually, your science, very interesting stuff indeed your reply, probably said it before, your knowledge on the subject diabetes never ceases to amaze me.

Thanks again to you and BlueSky, I'll now file your replied comments on my diabetes folder for future use.

[alura]

Wow! This is what I signed on for! Thanks, Buddy for asking what I didn't know how to ask and thanks to BlueSky and Frank. I didn't take my diagnosis seriously enough at first, partly because my primary care physician didn't seem concerned. I have an appt tomorrow with an endo and some of the points you raise will be on my list of questions. I have had an ongoing romance with carbs all my life which, while I was younger and thinner, didn't seem to have any effect. Now, I understand too late what I could have done differently. Again, thanks you to you guys and all the other great posters!

[Rad Warrier]

Originally Posted by alura

I have had an ongoing romance with carbs all my life which, while I was younger and thinner, didn't seem to have any effect. Now, I understand too late what I could have done differently. Again, thanks you to you guys and all the other great posters!

Hi Alura,

The following most recent post of mine may be of interest to you: http://www.diabetesforums.com/forum/404494-post1.html

Regards,
Rad

[REDLAN]

some answers for your questions, which may not match Bluesky & Frank

1)The importance of carbohydrates!

One of the 4 main macronutrients, somebody forgot to mention alcohol . The body's primary short term fuel is glucose. It's used solely by brain and neural tissue - the brain can use ketones, but it usually takes a couple of days of starvation to enable ketone metabolism by the brain. It is important for muscles. The major benefit is that energy can be derived from glucose without an adequate blood supply or oxygen - fat metabolism needs oxygen. Sprinters are primarily burning glucose.

2) What happens if we don’t get enough carbohydrates?

Simple, glucose is so important to the body, it will synthesize it from other sources - usually protein, but the body can also derive glucose from glyceride (a component of fatty acids)

How do we get carbohydrates from our diet?

mostly starches - grains, pototoes etc. But also simple sugars as found in fruit, honey, and the stuff that is added to bread cakes sweets etc. Starch is simply a long chain of glucose bonded together. Much is made of simple versus complex sugars. According to your body there is virtually no difference - starches are broken down about as quickly as regular sugar.

How much carbohydrates should we eat?

There is the recommended ADA daily allowance - my personal opinion is that this is largely hogwash. The simple fact is that humans consume a very wide variety of foods and seem to thrive quite happily on a wide variation of food intakes. What we can't tolerate is a very low fat intake (10% is about minimum) or a very high protein intake (35% or more as daily intake).

It is possible to survive on an extremely low carb diet. The problem with this diet (also called ketogenic - and advocated by Bernstein et al) is that few people can tolerate it, and the problem is consuming enough vegetables etc to ensure adequate vitamin intake. The few indigenous peoples that eat ketogenic diets (inuit) have very specialised diets to ensure adequate vitamin intake. You will not run out of carbs - although your ability to sustain high intensity exercise would be compromised.

Aren’t carbohydrates fattening?

Well this is the theory of Taubes - and I know he is very popular, but there is no evidence that his hypothesis is correct. I read an article by Taubes and tracked down study authors (referred to by Taubes) looking at low carb versus low fat diets. After 12 months there was no difference between the 2. This finding is typical of studies comparing low-fat versus low carb diets. There is overall a slight advantage in favour of low-fat diets for weight loss (by slight I mean a few pounds). There is the Israeli study which gets referred to in this forum, which shows an advantage to the low carb diet but the way the results are calculated produce a low-carb bias

What does the glycaemic index of carbohydrates means?

This was a popular notion, along with the idea (unsubstantiated) that kids eating sweets would induce hypoglycemia and therefore concentration problems due to high levels of insulin.

In truth nobody sits down and eats 100g of potatoes at single sitting without eating anything else. By the time your potatoes are mixed with gravy and a steak, the GI is anyone's guess.

Can low carbohydrates diet really help with weight-loss?

no better than a low-fat one. I refer you to above.

In type 2, weight loss and exercise are the 2 things that come up time and time again and have been shown to achieve an improvement in symptoms in real studies with real people (rather than rats).

[xMenace]

Carbohydrates as we typically know them, primarily refined grains, are a high source of Omega 6 (n-6) fatty acids. I tell people that n-6 fats are constructive fats while n-3 (Omega 3s) are lubricating fats. I don't really know the difference, but it's an analogy I read somewhere. Too much n-6 is thought to lead to fat related problems like CVD and diabetes.

The "Western diet" has many more n-6 fats than we need:

Omega-6 fatty acid - Wikipedia, the free encyclopedia

Some medical research suggests that excessive levels of n−6 fatty acids, relative to n−3 fatty acids, may increase the probability of a number of diseases and depression.[1][2][3]

Modern Western diets typically have ratios of n−6 to n−3 in excess of 10 to 1, some as high as 30 to 1. The optimal ratio is thought to be 4 to 1 or lower.[4][5]

If we go back to the Eskimo diet, largely ocean meats and fats, it is thought the reason they did so well with it was its high n-3 fat content. All their food lived directly or indirectly off of photisynthesis based life forms which is what produces n-3 fats. n-6 are fats stored by seeds for new plants to feed off of.

Not only are our current diets based on grains but the meats we eat tend to be grain fattenned as well. I feel a carb reduction alone is not enough. We need to also move towards grass fed meats and most fishes. I do have concerns about farmed fish.

[alura]

Originally Posted by Rad Warrier

Hi Alura,

The following most recent post of mine may be of interest to you: http://www.diabetesforums.com/forum/404494-post1.html

Regards,
Rad

Rad, thanks for the info and link. Intellectually I realize that D was already in my genes - my brother has TY 2 - but still wonder if somehow I "caused" it to happen with a poor diet. As always, so much good information here......

[RedRD]

I realllly don't want to get on a soap box here, and totally respect everybody's individual plan that works uniquely for them.

BUT - carbs SHOULD NOT be the enemy. All diabetics (T1 and T2) can, in theory, follow a 50-35-15 or 50-30-20 % diet (%calories from carbs-fat-protein). Yes, our bodies can produce glucose, but a VERY insufficient process with not-so-good byproducts. Ketones being one of those byproducts. If your physician is prescribing enough meds and you are following a sensible diet (avoiding simple, high-carb foods; avoiding unhealthy, high-fat foods), then your BG levels should be okay. The problems w/this? 90% of the time, your MD opts for the easy way out, which is letting you do a low-carb diet, which 90% of the time, compliance becomes an issue. And, they are almost always high-fat and high-protein (neither of which are good). And, RDs admittedly often prescribe too many carbs. But 50% of calories is just the prescription of a healthy nutritional regimen for "normal" - and shouldn't it be possible for us to follow a "normal" regimen?

Carbs make us fat if WE EAT TOO MANY OF THEM.

Eating too much of ANYTHING does the same thing.

TOO MANY CALORIES (no matter the source) = FAT

Unless, of course, you are putting your body into starvation mode with a high-protein diet - which glucogenesis plays a role in...)

Hope this doesn't come back to bite me in my big butt...lol (see Shutterbug's thread on big butts)

[fgummett]

OK... just because you say something does not make it a fact... even if you put "very" or "extremely" in front of it OR PUT IT IN UPPER CASE or even BOLD.

This same - low-fat, 50% carbs, normal, balanced, counting calories - dietary advice has been handed out for at least the last 50 years... do you really think it is working... I don't think so... why not?

Look at even your choice of words, "avoiding simple, high-carb foods; avoiding unhealthy, high-fat foods"... why are the "bad" carbs characterised as just "simple" while high-fat is "unhealthy".

By the way can you please (as a professional) cite me an actual scientific study which shows that high-fat food is "unhealthy"..? Not a quote from an "expert" but an actual study. For that matter, please show me where ketones or high-protein are unhealthy.

Where do you get these "90% of the time" figures from... can you please quote your source or did you just grab them out of thin air to try and make a point? I'd much rather have a discussion that revolves around proven facts.

As REDLAN points out above, the low-carb is at least as good as the low-fat... in terms of compliance and weight-loss... but what he forgot to mention is that the low-carb improved lipid profile (at least HDL-C and Trigs) over the low-fat. In addition, people on low-carb report a loss of hunger cravings... so why is low-fat the preferred method again?

Another point about the studies REDLAN mentioned above is that at 6 months the low-carb was ahead in weight loss, but at 12 months both low-fat and low-carb where equal... I strongly suspect that this occured becauis during that later 6 months, carbs where incrementally added back to the low-carb diet.. a la Atkins.

[fgummett]

Originally Posted by fgummett

OK... just because you say something does not make it a fact... even if you put "very" or "extremely" in front of it OR PUT IT IN UPPER CASE or even BOLD.

I probably meant to put a smiley at the end of that... I did not mean it to sound so harsh but I was rushing to respond before leaving for work.

I still maintain that I would rather discuss this with facts and reason.

Here is a recent thread that includes discussion of the studies mentioned by REDLAN and others... Why Diabetes lead to Obesity ?

[Gary_W]

The arguments regarding Inuits doing well on low carb sway me about as much as the arguments that Japanese people do well on a diet of rice and noodles sway the dedicated low-carber. Different strokes, and (given the right person and other lifestyle choices) it is clearly possible to live pretty well on any kind of fuel.

Whilst I appreciate how useful low carb diets can be to reduce spikes / reduce insulin requirements etc. I do tend to worry a little about a Western person with a Western lifestyle who is going to eat Western-style fats and proteins doing low-carb for life. The Westerner's fats and proteins are not likely to come from whales, fish and seals (yes, I know I'm generalising there but you get my drift).

I realise that the body will lay down excess carbohydrate as fat, but fat layed down due to excess carbs has not had to travel through the digestive tract.

Is there any evidence to show what effect a diet that is very high in fat vs carbs has on the digestive tract? I have no references to quote here, but go by generally held truths (which may be old wives tales, you tell me...) regarding gallstones being caused by a high fat diet and that bowel cancer rates are increased by eating a diet high in fat. I can see why some folks low-carb but doesn't it worry you that by treating diabetes in an effective manner you may be causing harm to other aspects of your system? I know that SOMETHING has to kill you in the end, but the idea is to minimise risk in as many areas as possible. Is low-carbing a case of reducing risk with diabetes but increasing risk elsewhere? I'd appreciate your thoughts.

It just seems to me that doing everything in moderation and nothing to excess is no bad thing. I agree completely that the Western diet contains too many carbs, but it also contains too much of everything else as well

I am, of course, speaking from the fortunate position of being able to have a highly varied diet that I enjoy whilst for the most part keeping my numbers fairly civilised. My position regarding low-carb and me may change if my body no longer tollerated the variety as well as it currently does.

Gary

[fgummett]

Gary, you raise some interesting points for discussion. I am not aware of any GI tract issues associated with eating a higher-percentage of fat. I understand that recently published long-term studies have discredited the idea the fibre is protective of the GI tract.

I would ask you to consider why you asked, "Is low-carbing a case of reducing risk with diabetes but increasing risk elsewhere?" instead of, "Is low-fat eating a case of reducing risk in one area but increasing risk elsewhere?" both are equally valid questions, and yet the default position seems to be that it is the low-carb which has to be on the defensive.

Fat is not a demon... many physiological systems including the brain rely on a careful balance of fats.

By the way, I do not believe that the traditional Japanese diet was chiefly rice and noodles.

[xMenace]

Gary,

My previous post points out why simply moving to western meats and fats might be a bad idea.

Many societies besides the Inuit have and do thrive on native diets. The common factor amongst them all is a lack of REFINED carbs. I won't tell anyone to do without carbs. I certainly don't, but all the powdered grains, sugars, and HFCS we eat are simply not natural. I'm sure none of any of our ancestors' diets contained 50+% of carbs nor the quantity of refined sugars that we see today.

Eat food. Not too much. Mostly plants!