Diabetes 2002: Dr. Grimshaw’s Guide, Part III

Carbohydrates: The Good, The Bad, and The Ugly
“But I thought all carbohydrates were good,” is something we hear a lot. The Ornish, the Pritikin and other diets have pushed the idea that very low fat (and high carb) diets are the answer to heart disease and diabetes.  Unfortunately, ‘taint so!

The Problems: non-fat or low-fat foods, especially snacks, use simple sugars instead of fat for flavor.  And these sugars are Bad!   They

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promote tooth decay

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cause blood sugar “spikes”

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raise insulin levels  (especially in type 2 diabetes or Impaired Glucose Tolerance)

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raise triglycerides (which are so toxic to the linings of your blood vessels that they can be paralyzed for 4 hours after such a meal).

The Insulin Issue: Insulin brings sugar down in the blood by helping cells (particularly muscle and liver) bring sugar inside, to be stored as glycogen.  If your cells have enough glycogen, the extra sugar gets stored as fat.  Excess insulin can:

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promote the creation of toxic trigylcerides

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inhibit the burning of body fat

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inhibit the use of fatty acids for energy

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inhibits the release of growth hormone (GH).  GH is essential to muscle growth and renewal. GH is released in large amounts after you exercise and right as you fall asleep.  Eating a simple sugar snack after exercise or within a few hours of sleep will abort the GH release

    And so you ultimately store more body fat, have less stamina and decreased metabolism and increased weight gain when you eat foods high in simple sugars!

Enter Atkins and Variants:
The above is the basis for the high protein, low carbohydrate diets of Dr. Robert Atkins, our old friend Dr. Joseph Hickey, and others.  If you don’t eat sugar, you don’t get the insulin spike, the triglyceride release, and the growth hormone response is normal.  In essence, your body thinks it’s starving, and you burn stored fat!
Readers of these pages know that there’s been little long-term testing of the Atkins approach.  But short term trials of up to 18 months have shown no problems.  Many physicians - including some (but not all) cardiologists - are quite leery.  

Can We Finesse This?  For selected patients, we use a modified carbohydrate restricted diet.  This is high in:

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lean animal protein such as chicken

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fish rich with omega 3 fats

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nuts

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avocados

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low carb vegetables

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egg white

Talk With Us!
    We’ll tailor your diet to YOUR needs, based on blood pressure, cholesterol and sugar control as well as heart and vessel risks, body mass and your own experiences.  We could try to “tell you” what to do (which never works).  
    Instead, we’ll ask you what you’ve done, what you’re doing,  and what you hope to do. This works!

The Glycemic Index (GI) is a measure of the rate at which carbohydrates are converted into blood glucose.  Obviously, from what we’ve been discussing, foods that cause a rapid rise in blood sugar - a high glycemic index - will worsen diabetic control and raise triglycerides (another way besides cholesterol that you carry fat in your blood).  An index under 100 is considered good.  Generally, the higher the fiber, the lower the GI.  

Some foods with good GI’s:

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whole grain bread

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dried peas

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lentils and beans

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barley

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high protein pasta (Barilla)

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peanuts

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soybeans

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sweet potato

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milk

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plain yogurt

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grapefruit

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cherries

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Foods with bad GI’s:

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white bread

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white pretzels

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white rice

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corn flakes

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Rice Krispies

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dates

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fruit juice