I know, I know, but carbohydrates increase blood glucose levels I hear you say. Well this post is for the carb haters out there. I’m going to explain why carbohydrate containing foods aren’t actually bad and how you can still include them in your diet.
Carbohydrates get a bad rep. They are the primary nutrient that increase blood glucose levels and therefore are the obvious topic of debate on diabetes care.
Whether you’re type 1, type 2, type 3 or suffering gestational diabetes, my conversations in clinic and education are often centred around carbohydrate management. Often the perception is because carbohydrates increase glucose levels they must be bad. When in fact nothing could be further from the truth.
Let’s be clear though. I’m referring to the nutritious carbohydrate containing foods such as wholegrain, oats, seeded varieties, vegetables, fruits, beans, pulses and lentils as opposed to their refined counterparts. Dietary advice has never been to eat refined carbohydrates. When we talk about eating carbohydrates we are talking about choosing the healthier options.
This might likely ruffle a few feathers, especially amongst the carb hating community, but today I’m giving you 8 reasons why you should be eating carbohydrates.
1. Carbohydrates aren’t the reason you have high glucose levels.
Regardless of the type of diabetes you have, it is the diabetes which causes high glucose levels, not carbohydrates.
In type 1 diabetes, the name of the game is matching your insulin to your carbohydrate intake. If you get this wrong, your glucose levels will increase or decrease and sometimes dangerously so.
In type 2 diabetes, carbohydrates aren’t the problem, it is your bodies inability to process these properly. 90% of type 2 diabetes cases are weight related and therefore the issue isn’t carbohydrates but rather a lifestyle issue. If the disease worsens there may be a place for a low carbohydrate diet. However, this is the disease not the carbs causing the issue. Therefore, a lower carbohydrate diet is simply treating the symptoms of the disease. Someone without diabetes having a similar diet would tolerate the carbohydrates just fine.
Gestational diabetes may be the exception to rule here. Carbohydrates still aren’t a bad food but due to the hormonal response of the placenta, these ladies can struggle to control their glucose levels with even modest amounts of carbohydrate in the diet. Add to this the glucose targets in pregnancy are very strict it can be difficult to manage a high level of carbohydrates in their diet.
Fibre is a non digestible carbohydrate. It provides no energy but improves gut health. Eating lots of fibre can help lower cholesterol, decrease blood pressure, improve glucose levels, reduce weight and the list goes on. Fibre also improves the good bacteria in your gut. More research has been going into this in recent years and we are finally beginning to appreciate the benefits of this. Good bacteria appears to help with reducing obesity risk and improve overall health.
Fibre is found only in carbohydrate containing foods. These include starchy carbohydrates, vegetables, fruit, beans, pulses and lentils.
People should ideally be eating 30g of fibre every day. That roughly equates to eating your 5 a day MINIMUM plus some starchy carbohydrate.
A low intakes of fibre is strongly associated with higher levels of cancers, particularly colon cancer.
3. Exercise performance
This one might not be for everyone but for those exercisers amongst you, listen up. It is well documented carbohydrates improve sporting and exercise performance. A lot of research has demonstrated this time and time again.
A prime example is looking at exercise time to exhaustion studies. Time to exhaustion is significantly delayed when people ingest a carbohydrate containing mixture. In fact, this doesn’t even need to be swallowed. Just swirling it in your mouth and spitting it out improves exercise performance.
I hear a lot of carbohydrate haters swear they thrive during exercise on low carbohydrate diets. However, the evidence is clear, carbohydrates improve performance. People on low carbohydrate diets will not be able to hit the levels they are truly capable of during competition.
4. Weight reducing
Low carbohydrate diets may help you lose weight faster at first but long term they do not yield better results. In fact, higher carbohydrate containing diets tend to be more sustainable. Therefore, people aiming for a lifestyle change are more likely to stay on their plan with higher carbohydrate intakes.
It may be a slower burner but does it really matter how long it takes if you’re able to maintain your weight loss. With faster more radical dietary approaches often dieters relapse and regain the weight. As a result, low carbohydrate dieters may never really make sustained progress. There are only a select few individuals I’ve encounter who can maintain low carbohydrate diets long term.
Carbohydrate containing diets also help to fill you up for longer, especially if choosing the healthier versions. You’re therefore less likely to pick and snack on unhealthy options or eat convenience food.
5. Vitamins and minerals
It’s tempting to get locked into one or two dimensional thinking about nutrition. Often people are only concerned with weight management and blood glucose levels. These are important but they aren’t everything.
There’s a larger picture at hand. All food provides nutrients in one form or another. Therefore, we need to consider this. Carbohydrate containing foods are some of our best sources of iron, folate, niacin, fibre, beta carotene, vitamin c and plenty of other vitamins and minerals.
Without carbohydrate containing foods in your diet it will more than likely be nutritionally deficient.
6. Lower incidence of disease
Some of my patients are quite vocal on social media explaining how carbohydrates cause diseases like diabetes. They explain, amazingly, since they cut out most of the carbs in their diet they have had tremendous results. I solute them for it too. The part they leave out though is they also lost a load of weight, had a lifestyle overhaul, no longer eat takeaways, drink alcohol less often, exercise and don’t eat refined unhealthy carbohydrates.
Countless studies have shown a beneficial effect of eating healthy carbohydrates in reducing disease risk. Examples include reducing diabetes, cardiovascular disease and cancer risk.
Not bad for a commonly perceived unhealthy nutrient.
In order for this benefit to be truly utilised you need to be eating the high fibre carbohydrates. Therefore, carbohydrates do not cause disease if choosing the healthy options. In fact they reduce the risk of it.
7. Carbohydrates are your body’s first choice for fuelling the central nervous system.
Think of the central nervous system as the master computer of the body. It includes the brain and the spinal cord. Hopefully I don’t need to make a case for why the brain is important.
Carbohydrates are the preferred energy source by the central nervous system. In times of low carbohydrate intake the brain can switch to fat metabolism and use ketones as its brain fuel. However, it’s not as happy as when using carbohydrates. Hence why it chooses carbohydrates first line for its energy supply.
This is why when eating low carbohydrate containing diets you can become sluggish and grouchy.
8. It’s more about calories than carbohydrates
This point is more for the type 2’s. If you are in an energy deficient state i.e. you are taking on less calories than you need, then it doesn’t matter if your diet is low or high carbohydrate.
A good analogy for this is to think of your petrol tank in your car. If you over fill it the petrol comes spilling out onto the pavement. I liken this overflow to high glucose levels. If you over eat carbohydrates you are likely to experience hyperglycaemia with diabetes. Like cars, everyones petrol tank/tolerance to carbohydrates will have different capacities. As long as the petrol tank does not exceed its capacity you will not experience high glucose levels. Instead the fuel should be used up to keep you going.
The diabetes remission diet itself consists of 59% carbohydrate. If you’re not familiar with the diet I have blogged about this previously here. 59% carbohydrate intake is more than someone would likely eat in a normal diet. However, because the diet is only 800kcal per day it actually reduces glucose levels over time.
Only in insulin deficient states like in type 1 diabetes or long term type 2 diabetes will low calorie high carbohydrate intake cause hyperglycaemia. This is because type 1’s suffer a complete insulin deficiency. Therefore, any carbohydrates without insulin will increase glucose levels. Whereas long term type 2’s retain insulin producing capabilities but this may be less compared to normal and will not work as efficiently.
One nice study I found demonstrates this energy deficient but high carbohydrate theory nicely. Published in the American Journal of Clinical Nutrition, they studied 2 groups of people and prescribed one group a low carbohydrate diet and the other group a high carbohydrate diet. The results are in the table below.
LC means low carb and HC means high carb. The low carbohydrate diet consisted of 14% total carbohydrate and the high carbohydrate diet consisted of 53%. Both groups limited saturated fat to 10% as per nutritional guidance.
As you can see all the measures they studied improved very similarly regardless of the diet they followed. Granted the low carbohydrate diet participants required fewer medications. However, with eating fewer carbohydrates there is no need to combat these with medications. If the low carbohydrate group added carbohydrates back into their diet they would require very similar amounts of medications to the high carbohydrate group. Therefore, I return to point 1 of this list. The problem isn’t carbohydrates in the diet but rather the patients inability to metabolise them properly due to their diabetes. Therefore, further weight loss and lifestyle change is needed for a better glucose response regardless of the diet used.
Hopefully you can see there are many benefits to eating carbohydrates. For our type 2’s, without making a lifestyle change I will concede we may need to manipulate the amount of carbohydrates in their diet. Otherwise hyperglycaemia will likely occur. If these patients took action through lifestyle change, they could enjoy carbohydrates in their diet without the problem of hyperglycaemia.
For the type 1’s, there is no reason to exclude carbohydrates from your diet. As long as it is accounted for with the correct amount of insulin.
Carbohydrates are a healthy food group if choosing the correct options. I could provide countless photos of athletes who are the pinnacle of fitness who eat carbohydrates. Probably lots of them too. What these athletes do differently though is control their weight, choose healthy foods and remain active. I’m not saying everyone needs to be an elite athlete but there can be a happy middle ground.
So please don’t feel carbohydrates need to be excluded from your diet if this is something you have come across.