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The “Skinny” on Carbs
By Kevin Brown

If you’ve ever been on a weight-loss diet, or if you have diabetes, you’re probably familiar with counting carbohydrates. However, if you’re new to dieting or have been recently diagnosed with diabetes, counting “carbs” may seem like a foreign language. We posed some questions about carbs to Susan Zikos, RD, LDN, CDE, a registered dietitian and diabetes educator at Ohio Valley Hospital, and she gave us the “skinny” on what it exactly means.

So, what are carbs and why are they important?
“Carbs, or carbohydrates, are molecules that have carbon, hydrogen and oxygen atoms,” Susan explains.

“In nutrition, ‘carbs’ refers to one of the three types of nutrients in our food. The other two are protein and fat. The main purpose of carbohydrates in the diet is to provide energy. Most carbs are broken down into glucose during digestion, and we use them for energy in muscles and our brains. Excess carbs are turned into fat for later use.”

Are there different types of carbs?
Susan notes that dietary carbohydrates can be split into three main categories: sugars, starches and fiber.

“Sugars are sweet, short-chain carbohydrates found in foods. Examples are glucose, fructose, galactose and sucrose. These are broken down into simple glucose in the digestive system,” she says.

“Starches are long chains of glucose molecules, which eventually are broken down into glucose in the digestive system.”

“Humans cannot digest fiber, but fiber can feed the growth of good bacteria in the digestive system, much like the probiotics that we pay extra for. Fiber is an exception. It does not provide energy directly, but it does feed the good bacteria in the digestive system. These bacteria can use the fiber to produce fatty acids that some of our cells can use as energy.”

Which foods contain carbs?
According to Susan, carbohydrates are in all the sugary or starchy foods we eat.

“Carbs are in starchy items like breads, rice, potatoes, macaroni and noodles. Carbs are also in some less obvious foods like milk and yogurt. And, of course, fruits and fruit juices are excellent sources of simple sugars. Pies, cakes, cookies and donuts, though they are made with flour, have added sugars which make them sweet,” Susan explains.

What do nutrition labels tell me about carbs?
“Right now, the Nutrition Facts Label tells us many things. It tells us what the serving size is for the product and how much protein, fat and carbohydrate are in a product. It also tells us about other nutrients like sodium and some vitamins. The Total Carbohydrates per serving is expressed in grams, which is helpful for people with diabetes who may want to limit their intake of carbohydrates,” she says.

“The label also lists the Dietary Fiber content, which is helpful if you want to increase fiber intake. Recommended levels are 18 to 35 grams of fiber per day. Americans as a whole do not reach those levels because of the amount of processed foods in our diets,” she says.

Susan notes that the Nutrition Facts Label is now in the process of revision and most labels will change by Jan. 1, 2020 to more accurately reflect the serving size and nutritional content of each food. “’Additional sugars’ will reflect sugars that are added, rather than natural sugars that are in foods. These changes will help us to make better choices.”

What are good carbs and bad carbs?
Susan says that no food or carbohydrate should be classified as 'good' or 'bad'.

“This just makes us feel guilty as we eat it. And, we all eat foods that we know are not good for us from time to time, however, some carbs are more 'worthy' than others. Carbohydrates in their less processed forms - vegetables, whole fruits, whole grain breads, cereals and pastas - have more fiber in them and also more nutritional value,” she explains.

What do carbs have to do with digestion?
“The fiber associated with healthy carbohydrates helps to speed along the digestive process, and prevent constipation. Some fiber, especially those from fruits, vegetables and whole grains, also contain prebiotics which are the 'food' for the probiotics or 'good bacteria' in our digestive systems,” Susan notes.

“Fiber also helps us to feel full faster and for a longer time. Another benefit of fiber is that it can also help cut your risk of certain cancers, lower your cholesterol, and help keep your blood sugar balanced.”

I’m trying to lose weight. Which carbs should I avoid?
“In general, we should avoid the carbohydrates made from white flour and white rice,” recommends Susan.

“Many of the nutrients and most of the fiber have been removed from those foods. A good number of popular diets, including Atkins, Keto, Paleo and South Beach, limit carbs to some extent, with some eliminating them totally for a period of time. They tend to work because they eliminate those low fiber and high calorie snack and comfort foods that we gravitate to when we are tired or bored. However, these are not sustainable eating patterns for long periods of time, so people go back to their old eating patterns and regain the weight.”

What role do carbs play in diabetes?
Susan notes that this could be an article in itself. “In short, diabetes happens when the pancreas does not produce enough insulin to clear out glucose (from carbs) from the blood and put it into the cells for energy. It can also occur when the insulin that is in the blood is not effective in helping the glucose get into the cells,” she says.

What carbs should I avoid if I have diabetes?
Susan wants people, including those with diabetes, to change their lifestyle choices so they eat healthy foods, like those recommended by the USDA's My Plate.

“For people with diabetes, as well as the rest of us, this entails limiting concentrated sweets – ‘white foods’, like those made with white flour, white rice and even white potatoes, while increasing the amounts of higher fiber fruits and vegetables and whole grains, lean meats and beans,” Susan says.

How can I develop a healthy diet plan?
Susan recommends following the “My Plate" guidelines from the USDA Center for Nutrition Policy and Promotion (www.choosemyplate.gov). They have excellent suggestions to eat the right foods, limit portion sizes, and improve health.

Where can I get more information about carbs?

“All three major nutrients (protein, fat and carbohydrate) are important, so any further reading should be about all of them in conjunction with building a healthy diet,” Susan says. “If high blood glucose levels or obesity are a problem, a person can see a registered dietitian or certified diabetes educator for further information on diet and exercise.”

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For those seeking outpatient nutritional services, Ohio Valley Hospital’s Nutrition Services offers an Outpatient Dietitian, Nutrition Counseling services, and Diabetic Counseling. More information is available at www. ohiovalleyhospital.org or by calling (412) 777-6205.

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