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Understanding Carbohydrates

Carbohydrates fall into a three broad categories :

Simple sugars – usually taste sweet and cause a rapid rise in blood glucose levels.  These tend to evoke a rapid sharp peak in insulin secretion that dissipates relatively quickly.  Table sugar (sucrose), milk sugar (maltose), fruit sugar, honey, etc. are examples.  A common misconception is that the sugars in fruit are somehow ‘better for you.’  All carbs in the category cause the body to react essentially the same.

Starches are found the grains, including wheat, corn, rice, potatoes, etc.  These are the complex carbohydrates. They tend to cause a  slower and lower rise in blood sugar when they are consumed.  However, the insulin excursion is significantly prolonged, which ultimately results in a bigger total secretion of insulin. Interestingly, from a carbohydrate content, bananas are more like a grain than a fruit.

Fibers are long chains and weaves of carbohydrates that are primarily derived from the cell walls of plants.  As they are not well digested, the carbohydrates aren’t absorbed to any significant degree and thus don’t cause a rise in blood glucose or insulin.  These carbohydrates are not to be counted toward the daily load.

Fiber is extremely important in the diet.  The Insoluble Fiber cleanses the digestive track, promotes a feeling of ‘fullness’ and helps with bowel movements. The soluble variety binds several elements in the diet and the body, including cholesterol. The soluble fiber in Cheeriosâ is partially what confers its ability to lower cholesterol.

The carbohydrates themselves are not in of themselves ‘bad.’  It is the body’s response the carbohydrates, namely the insulin that the body has to secrete to get the sugars into the cells of the body that is the process that needs to be addressed.

To appreciate some of the carbohydrate values of foods, start by understanding table sugar (sucrose.)  Sucrose is a simple sugar.  A teaspoon (the amount that is one pack) of sugar is 4g of carbohydrates, 16 calories.   A slice of white bread is about 100 calories. Of that, about 80 calories are carbohydrates.  It is a blend of simple sugars and complex. A common misconception is that whole wheat bread is ‘better’ for you than white bread. While whole grain foods may have more nutrients but it has the same amount of carbohydrates.  While some whole grain breads may have a slightly higher fiber content, the simple and starch carbohydrates contents are still about the same.  The same is true with respect to whole grain or wild rice, whole wheat pasta, etc. For the purposes of carbohydrate management, a grain is a grain. Same is true of organic foods.  The body’s insulinogenic response is the same regardless of the ‘quality’ of the grains. Remember, corn is a grain – not a vegetable.

A key focus of dietary adjustment as part of the SHWW program is the decrease in the total carbohydrates

Understanding that the carbohydrates are what drive the secretion of insulin, the main strategy in dietary adjustment involves carbohydrate reduction both in total quantity and in percentage of daily calories.

Using a typical 2000 calorie diet as an example, about half (1000) of the calories come from carbohydrates. 1000 calories is equivalent to 250g of carbohydrate.  By decreasing the carbohydrate load to 200g per day, that lowers the carbohydrate calories to 800 and the percentage of carbohydrates drops to 40% – but the total calories have not changed – nor has the actual amount of food!

Using a standard ‘carbohydrate counter’ guide, the clinician and patient should add up and analyze the carbohydrate load for a few focused days of the week that patient feels are ‘typical.’  Interestingly, the carbohydrate (and calorie) loads do not vary much day-to-day, week-to-week for most people.

Participants are often surprised to see what they are actually consuming – with regards to quantity, types and frequency of certain foods

The SHWW clinicians have made several observations and seen several reproducible patterns:

  1. Most diets are high (around 50% or more) in carbohydrate as total calories.
  2. Many people have some form of carbohydrates at every meal.
  3. Of the carbohydrates people do eat, most are in the form of complex carbohydrates, especially bread items.
  4. Between meal snacks are almost all carbohydrates.
  5. Beverages have more carbohydrates (simple sugars) than most people realize.

Often, just the awareness of these facts can cause changes in eating patterns that can change metabolism and improve weight loss.