The Truth About Carbohydrates

-- By Becky Hand, Licensed & Registered Dietitian


It’s true. A carbohydrate-rich diet can inflate appetite and girth. Low-carb diets do promote short-term weight loss, but are accompanied by some severe dangers. So what should you do? The truth is, you can have your carbs and eat them too—you just have to know how to choose them.

The Truth about Carbohydrates

• Carbohydrates are the body's ideal fuel for most functions. They supply the body with the energy needed for the muscles, brain and central nervous system. In fact, the human brain depends exclusively on carbohydrates for its energy.
• Carbohydrates are found in fruits, vegetables, beans, dairy products, foods made from grain products, and sweeteners such as sugar, honey, molasses, and corn syrup.
• The body converts digestible (non-fiber) carbohydrates into glucose, which our cells use as fuel. Some carbs (simple) break down quickly into glucose while others (complex) are slowly broken down and enter the bloodstream more gradually.
• During digestion, all carbohydrates are broken down into glucose before they can enter the bloodstream where insulin helps the glucose enter the body’s cells. Some glucose is stored as glycogen in the liver and muscles for future use, like fueling a workout. If there is extra glucose, the body will store it as fat.

All carbohydrates are not created equal.
There are basically three types of carbohydrates:

1. Simple carbohydrates are composed of 1 or 2 sugar units that are broken down and digested quickly.
   
   Recent research has shown that certain simple carbohydrate foods can cause extreme surges in blood sugar levels, which also increases insulin release. This can elevate appetite and the risk of excess fat storage.
   
    
2. Complex carbohydrates (also referred to as starch) are made up of many sugar units and are found in both natural (brown rice) and refined (white bread) form. They are structurally more complex and take longer to be broken down and digested.
   
   Complex carbohydrate foods have been shown to enter the blood stream gradually and trigger only a moderate rise in insulin levels, which stabilizes appetite and results in fewer carbohydrates that are stored as fat. Unrefined or ‘whole grain’ carbohydrates found in products like brown rice, whole wheat pasta and bran cereals are digested slowly. They contain vitamins, minerals and fiber which promote health. Fiber and nutrient-rich vegetables, fruits and beans which are carbohydrates also have many important functions for the body and are important for good health.
   
    
3. Indigestible carbohydrates are also called fiber. The body is unable to breakdown fiber into small enough units for absorption. It is therefore not an energy source for the body but does promote health in many other ways.

Simple carbs, complex carbs, and fiber are found in many foods. Some provide important nutrients that promote health while others simply provide calories that promote girth.

• Sugar, syrup, candy, honey, jams, jelly, molasses, and soft drinks contain simple carbohydrates and little if any nutrients.
• Fruits contain primarily simple carbohydrate but also valuable vitamins, minerals, fiber, and water.
• Vegetables contain varying amounts of simple and complex carbohydrates, vitamins, minerals, fiber, and water.
• Legumes such as beans, peas, lentils and soybeans contain complex carbohydrates, fiber, vitamins, minerals, and protein.
• Milk products contain simple carbohydrates along with protein, calcium and other nutrients.
• Grain products contain complex carbohydrates, fiber, vitamins, minerals, and protein. The amounts vary depending on the type of grain used and the amount of processing. Selecting whole grain options whenever possible is recommended.

What You Should Know About Low-Carbohydrate Diets
Following an extremely low-carbohydrate diet is disastrous, dangerous, and above all—boring! Carbohydrates are NOT the enemy. Including the appropriate amounts and types of carbohydrate-rich foods in your diet is essential for long-term health and weight loss/maintenance.

The Body’s Immediate Reaction to Very Low Carbohydrate Diets
When there is a severe deficit of carbohydrates, the body has several immediate reactions:

• With no glucose available for energy, the body starts using protein from food for energy. Therefore this protein is no longer available for more important functions, such as making new cells, tissues, enzymes, hormones, and antibodies and the regulation of fluid balance.
• When carbohydrates are lacking, the body cannot burn fat in the correct way. Normally carbs combine with fat fragments to be used as energy. When carbs are not available, there is an incomplete breakdown of fat that produces a by-product called ketones. These ketones accumulate in the blood and in the urine causing ketosis, which is an abnormal state. Ketosis does cause a decrease in appetite because it's one of the body's protection mechanisms. It's an advantage to someone in a famine (which the body thinks it's experiencing) to lack an appetite because the search for food would be a waste of time and additional energy.
• Due to the lack of energy and the accumulation of ketones, low-carb diets are often accompanied by nausea, headaches, dizziness, fatigue, bad breath, and dehydration.
• Because of dehydration and a lack of fiber, constipation can result.
• Exercise and fitness performance is reduced on a low-carb diet. Do not be surprised if your energy level is so low that you cannot make it through your normal workout routine.

The Long-Term Effects of Low Carbohydrate Diets
When you severely restrict carbohydrates, your consumption of protein and fat increases, which has several long-term effects:

• The risk of many cancers increases when fruits, vegetables, whole grain products, and beans are eliminated from the diet.
• Protein foods are also high in purines, which are broken down into uric acid. Elevated levels of uric acid in the blood may lead to needle-like uric acid crystals in joints, causing gout.
• Kidney stones are more likely to form on high protein, ketosis-producing diets.
• Over time, high protein diets can cause a loss of calcium and lead to osteoporosis.
• The risk of heart disease is greatly increased on a low-carb diet that is high in protein, cholesterol, fat, and saturated fat. A temporary reduction in cholesterol levels may be experienced, but this is common with any weight loss.

The Million Dollar Question
How do you include carbohydrates in you diet in a safe, effective, and controlled way? The “Please KISS Me" (Please Keep It So Simple for Me) plan for carbohydrate control is a wonderful tool that only contains 3 simple rules:
EDITED TO ADD - THIS DOES NOT PERTAIN TO MOST WLS PATIENTS - OUR DIET PROTOCOLS ARE GOING TO VARY AS OUR ABSORBTION IS DIFFERENT AS WELL AS SURGEONS PROTOCOLS
RULE 1: Include the following in your diet:

• Fruits: 2-4 servings daily
• Vegetables: 3-5 servings daily
• Whole grain breads, muffins, bagels, rolls, pasta, noodles, crackers, cereal, and brown rice: 6-11 servings daily
• Legumes, beans and peas: 1-2 servings daily
• Low-fat and non-fat dairy products: 3 servings daily

RULE 2: Limit the following to less than 2 servings daily:

• Fruit Juice
• Refined and processed white flour products (bread, muffins, bagels, rolls, pasta, noodles, crackers, cereal)
• White rice
• French fries
• Fried vegetables

RULE 3: Eliminate the following from your diet or eat only on occasion:

• Sugary desserts, cookies, cakes, pies, candies
• Doughnuts and pastries
• Chips, cola and carbonated beverages
• Sugar, honey, syrup, jam, jelly, molasses