I have to be honest, I’ve been dying to write this because of all the allied health professionals that consult me to “teach [their patients] carb counting.” No, no, and no I will NOT teach that. About half of those of you reading this are like “Yeah! Preach it!” and the other half of you are offended. Whichever side of the fence you are on, I hope you’ll keep reading!
This post is relevant to those with or without diabetes, but “carb counting” seems to be most often heard in the context of diabetes management. However, everything I’m about to tell you applies to “counting carbs” as well as “counting macros” for you gym dudes. Same poor advice if you ask me…
Most of this post is geared toward healthy people trying to prevent type 2 diabetes and those who already have type 2 diabetes. The only place that “carb counting” is actually very useful and necessary is in the case of type 1 diabetes. Insulin dosing in type 1 diabetes largely depends on the amount of carbs consumed. When I say “carb counting” is outdated, I am not referring to the type 1 diabetes population. HOWEVER, some of the information later in this post on quality of carbs (and overall food quality) consumed is relevant to the type 1 diabetes population (and all other humans too).
First of all, there is NO SUCH THING as a “diabetic diet.” If you are a healthcare professional, PLEASE stop telling patients that. If you are a person who has been told that, I’m sorry. Here’s a thought-bomb for you: what if the same exact strategies that help prevent diabetes also helped manage them? Seriously, think about that. If you develop type 2 diabetes, it’s not as though suddenly you have been given a life sentence in the prison of eating healthy. It’s just that eating healthy becomes a little bit more critical to your life.
Some individuals develop type 2 diabetes despite living a pretty healthy and active lifestyle. But the literature supports that those individuals are the exception, not the rule. If you’re a super-healthy person and out rock-climbing and such, but still developed type 2 diabetes, I’m not talking about you; relax. I’m talking about the other 95% of type 2 diabetes cases that arise from a breakdown in the metabolic system that results from lifestyle patterns over many years.
Ok – so here it goes. Sure, reducing overall intake of carbs can help a person with (or without) diabetes achieve better blood sugar levels and often weight as well. But let’s say that a person is given the common 45 grams of carbs/meal guideline that, admittedly, I used to often teach patients myself years ago. That means that I could simply have 1.5 refined hot dog buns for dinner and be “right on target.” How much nutrition would a dinner consisting of 1.5 hot dog buns be? Seriously? If we have a reductionist method of solely focusing on QUANTITY but not QUALITY of carbs/fat/protein/whatever, our long-term health inevitably suffers.
Our bodies are marvelous systems of inner machinery that requires nutrients to run much like a car requires gasoline. No matter how precise we are about “counting carbs,” we still need adequate fiber, magnesium, potassium, chromium, thiamine, B-vitamins, and many other vitamins and minerals in order to properly utilize insulin, blood sugar, and overall metabolism.
We need protein and fat to slow digestion (in a good way) to prevent blood sugar spikes; but we also need the NUTRIENTS provided from the foods rich in protein and fat (magnesium, selenium, iodine, zinc, copper, vitamin A, omega-3 fats, vitamin D…etc.). We need fiber to slow digestion (again, in a good way) to prevent blood sugar spikes. But we also need the NUTRIENTS that fiber-rich foods provide, and we need fiber for healthy gut tissue.
Our gut health is the center of our universe. If we don’t take care of our intestinal tract, we are more likely to have increased systemic inflammation, difficulty with managing weight, depression, and fatigue. Sound familiar? Those symptoms should sound familiar because they are ALSO major issues associated with those who have type 2 diabetes. Hmmm…
So what does all this mean? Can you have carbs or not? Well, yes, you can have carbs. But mainly a small quantity of good quality carbs is the goal; and the amount of carbs is nearly irrelevant if you’re not consuming adequate protein/fat/fiber.
Tips for those of you who are air-breathing kids or adults; healthy, or not-healthy; and those of you with no diabetes, prediabetes, or diabetes:
- Make your plate mostly non-starchy vegetables, some protein, and some fat.
- Reserve about ¼ of your plate for fiber-rich carbs, milk, and/or yogurt
- Fiber-rich carbs includes things like 100% whole grains, whole fruit (not juice), and starchy vegetables (like potatoes, corn, peas, beans, etc.)
- Remember, all of our carbs are competing for that little ¼ plate space; you might benefit more from trading one for another instead of having two options, for example.
- Drink water as your main beverage. Some plain coffee and/or tea is fine too!
- Make sure you’re choosing real foods.
- Real foods are those that have very minimal ingredients and have had the least amount of processing possible.
- Real foods mean the difference between orange juice (processed, even if fresh-squeezed) and an actual orange (real food).
- Real foods means having bone-in, skin-on chicken rather than boneless, skinless chicken breasts. (We need fat, collagen, lysine, proline, etc. from the chicken; “fat-free” is NOT health.)
As usual, there is so much more to say, but I will digress for now. Writing this is such a weight off my mind’s shoulders, as this topic has been ruminating in my head for quite some time now. Today the straw simply broke the camel’s back, as I read one too many chart notes indicating “carb counting” (and not even accurate advice anyway).
As always, please consider arranging an appointment with a registered dietitian nutritionist for more individualized, comprehensive advice on healthy eating in general, health conditions, sports nutrition, or any other nutrition-related topic of interest.
PS – I won’t be mad if you share this J