So, I want to talk about carbohydrate foods because they have the main
impact on the blood sugar. And so all of these foods shown here
are going to be digested and turned into glucose
and other individual sugars that enter the bloodstream.
Foods that have little or no carbohydrate would be flesh.
So, meat, chicken, fish, certain dairy products
have carbs. Milk and yogurt have carbs but cheese, cream cheese, and cottage
cheese have little to none. Cream and half and half also very low in
carbs. Eggs, tofu, seeds, nuts, nut butters, avocados all of
the fats, oils, butter, margarine, and then some of
the vegetables are so minimal in carbohydrate. Lettuce, for example, I think
there's two grams of carbohydrate in a cup of lettuce, one of which is fiber
so it leaves you with one gram. I think you burn more than that chewing the
lettuce. So I wouldn't count the lettuce, limes, or
lemons. So, why are carbohydrates important? So
first of all the main user of glucose is your brain. The brain uses more than
any other part of your body, except you know, if you're out
exercising the muscles are sucking it up as well.
But not only that, the foods, the carbohydrate food groups, carry
specific nutrients and plant foods like beans, whole grains, fruits, and vegetables
are rich in fibers and we'll talk about the benefit of soluble and insoluble
fiber later. But each food group has its unique, you
know, often are rich in certain vitamins and
minerals and they don't always cross over, that
that you know not not exactly the same. So a balanced diet is a
is a way to get the complement of nutrients that we need.
Carbohydrates are also naturally low in saturated fat. And as you know saturated
fat is linked to heart disease. So, when you ask you know, "How much of the
diet should be carbohydrate?" and this is where
there's going to be debate forever into the future, because not everybody's going
to agree on this. And so I'll look at a couple of the
things that are our standards. So, the 2015 to 2020
dietary guidelines are set by the Institutes of Medicine.
And in the left column what they're showing is
their guideline for the breakdown of carbohydrate, protein, and fat in the diet.
This isn't specifically for diabetes, this is the general guidelines for
healthy Americans. And they're saying, and it's a wide wide
range, 45 to 65 percent of calories should be carbs.
Now having done diabetes management for 28 years I'll say
60 65 is a lot. And I don't think most people with diabetes are going to
tolerate that unless they're riding their bike to Utah this weekend.
So you might, you know, you might not want to go on the upper ends.
The protein 10 to 35 is what they recommend as,
as part of the diet. And the fat 20 to 35 percent.
Now the diabetes care journal that I just pointed out
has done observational studies and looked at what the average intake is for
people with diabetes, and the average intake falls around 45 percent of the
calories coming from carbs. Some people higher, some people lower but
that's the average. And their protein was noted at 15 to 20
percent. And fat at 35 to 40. So most people fall
pretty close to what would be generally a, you know, guideline for a healthy
balanced diet anyway. In this case the fat content was higher,
a little bit higher, but provided that that's healthy fat, you
know, heart-healthy monounsaturated, polyunsaturated fats,
that doesn't mean that's a bad thing. We're going to talk about the different
types of fats in a bit. So, you know I'm throwing numbers out
there and then people are, you know, "What does that really mean for
me?" And so what I did was I crunched numbers just to give you a table that
you could look at and I did calorie intakes from twelve hundred to three
thousand. I don't know that anybody in the room
needs 3,000 calories but I've done, you know, diabetes management for 18 year
old football players who do, and so that's why there's such a big
table there. But I made four columns, remember that
they said 45 to 65 carbs, I did 45 to 55 and I added 40
on my own because plenty of people can get by on less carbs
and still have a healthy balanced diet. And a lot of people with diabetes strive
to be somewhat on the lighter side of carbs.
I'm just suggesting without going too low this might be a way of looking at it.
Now also there's a little guide up in the right corner,
calorieking.com, and what they have at calorieking.com is
a little button that says how many calories should I eat.
And you plug in your height, weight, gender, your exercise
level and it will crunch those numbers and say, "Hey
you probably need about 1800 calories a day."
If you want to lose weight, 1300, it gives you the buttons for, "Do you want to lose,
or stay the same, or gain weight?" And then you come up with a basic
calorie level. And then you could use this table to get an idea of how many
carbs that might be. I do want to point out that the Food and
Nutrition Board, Institutes of Medicine, National
Academies of Science have a minimum recommended amount of carbohydrate.
And that's called the dietary reference intake and that number is 130 grams. So
that's their studied number of the amount of carbohydrate suggested
for the basic, functioning needs. That doesn't include
exercise, it doesn't include the fact that some people are six foot tall
and have more muscle, so they're still suggesting calculating it based on
somebody's personal needs. But they're giving a
minimum of 130. And the funny thing is is when
you look at the table it says if your age is one to three 130
grams. If your age is four to eight 130 grams. All ages were 130 grams until
you got to pregnancy, is 175. So that would be where that number comes
from. So if you wanted to just bypass all of
those tables and all that math you could just say well what sort of a ballpark
amount of carbohydrate people might want to aim for and I broke
it out into women and men and then I gave three sections. Maybe
somebody who wanted to be on a lower carb intake, or somebody who was older,
more sedentary. A woman might be 30 to 60 grams at a
meal. And a man might be 45 to 75. Then you
have younger people who are more fit and more active
and, and you know more muscular, and they have lower metabolism, sorry
higher metabolisms, and they can burn more calories.
And so you can see that there's a variety of of things to choose from here.