Why Carbs Should Be the Base of Your Diet (Even For Diabetics)



           After giving a presentation on diabetes, I was asked what the “healthiest” food to eat. Answer: There is no single healthiest food.
What’s the healthy diet depends on your definition of healthy. This is different for everyone.
That said, here are some recommendations for everyone…

Acceptable Macronutrient Distribution Range (AMDR)
AMDR is a fancy phrase for how much carbs, fat, and protein are recommended by the Institute of Medicine:
45-65% Calories from Carbohydrates
20-35% Calories from Fat
10-35% Calories from Protein (10-25% recommended by Australian Ministry of Health)

Because these nutrient recommendations are a range, everyone can get them differently. Some people do very well on a high carb diet with 65% calories from carbohydrates. Diabetics are often told to eat closer to 50% calories from carbs, and some people do well with only 45% calories from carbs.

Why so many carbohydrates? What about low carb diets, like Atkins?

 
Low-carb diets are often used for weight loss short-term, but there are risks long-term.
In our bodies, most carbs are converted to sugar. Some carbs, like insoluble fiber, will pass out of us undigested.

Everyone, including diabetics, need sugar to survive. We need a minimum of 130 grams of sugar per day for our brain and our blood cells to function. We need additional sugar for energy.  Sugar can be stored in our muscles and liver and released when we need more energy, such as during exercise.

If we don’t get enough sugar, our body starts breaking down our muscles and fat. That’s why low-carb diets work for weight loss—your body will break down fat and you lose weight.

But, we don’t want our bodies to break down our muscles.  In severe cases, the body will even break down the organs, including the heart. Obviously, this isn’t good and can result in death.

What are ketones? What is ketosis or ketoacidosis?
While the body breaks itself down, it produces ketones. Ketones can be excreted by the body.
Sometimes, especially in diabetics, ketones build up and make blood acidic. This is called diabetic ketoacidosis. If left untreated, it can lead to coma. 

How do I avoid that? 
To avoid the body breaking itself down and producing ketones, everyone, including and especially diabetics, should eat at least 130 grams of carbohydrates per day. In type 1 diabetes, insulin administration is also required to help the body use sugar.

Are there exceptions? Who might benefit from a low-carb diet?
Patients with some medical conditions, particularly epilepsy, have found that following a low-carb diet and producing ketones improves their condition. These patients follow a ketogenic diet under medical supervision. Do not start such a diet without consulting a doctor.

Reminder: Eat a Variety
Although a carbohydrate-based diet is recommended by the Institute of Medicine, we should also eat protein and fat. A diet that removes any nutrient can have negative effects. Eat a varied diet to get a mix of nutrients.  

Comments

  1. Is that why I wasn't given what I ordered in the hospital?

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    1. It could be. If a diabetic patient does not order the minimum carbs set by the doctor, the food service staff at my hospital will add carbs and a bright orange note that says the meal was modified to meet the doctor's diet order. We make similar changes and notes for other diet modifications. Another possible reason you weren't given what you ordered is that something ran out. At my hospital, staff will put a note on apologizing for the substitution. From my past experience, not every hospital leaves a note explaining changes, but you should be able to call food service to ask.

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