Carbs demystified: to eat or not to eat?

I talk about carbohydrates (carbs) to my patients every day. To some I explain how they need to cut down and change the type of carbs they are eating, and to others I have to explain why they should introduce carbs back in their diet. Here is the thing: our body uses glucose, the most basic and simple form of carbs for energy. Everything else, including complex carbs, fats and proteins are converted to simple carbs for the most efficient source of energy. More importantly, our brain can mostly use glucose for its energy source. Evolutionary, the human brain started growing around the same time as carbs were introduced into our diet. One theory is that carbs provided the brain with an efficient source of energy, allowing it to grow. So, without carbs you are devoiding your body of an essential nutrition.

But why do carbs get such a bad rep and why are there so many low or no carb diets?

Well, it turns out that carbs are also the evil behind the obesity epidemic and a major cause of diabetes.

So, how is it that carbs are so important, and I recommend it to all my patients but at the same time they are so bad for you? Am I the worst doctor of all time?

It turns out that the kind of carb you eat makes all the difference. Carbs in their natural form are always surrounded by other healthy nutrients: healthy fats, proteins and fiber. So, natural carbs are harder to digest and have other nutritional values. But the food industry has learned that by removing all those healthy complex ingredients it can make more simplified, pure carbs. These processed carbs are easier to digest, last longer on the shelf (the fat in whole grain becomes rancid after a while), and have a much more addictive sweet tase. So, most of the commercially available carbs is simple and processed.

Whole grains are rich in fiber, proteins and minerals. Refined grains are stripped down to simple carb.

The biggest difference between complex and simplified carbs is how fast they are absorbed. Complex carbs, well, they are complex; it takes time for our digestive system to break them down, they are absorbed slowly and gradually after a meal. Processed carbs are already simplified by the food industry, they are devoid of all the fats, proteins or fiber in them; they are absorbed very quickly.

Once absorbed, the pancreas releases a hormone called insulin. Insulin is integral in helping our cells absorb the glucose we just ate. Amount of insulin released is proportional to how much glucose is absorbed from the digestive system in to the blood: Complex carbs lead to slow and gradual insulin release, simple processed carbs lead to rapid and large swings in insulin release.

Now here is the catch: we now know that rapid frequent swings in insulin is one of the main culprits of weight gain and diabetes.

So, processed simple carbs lead to rapid large swings in insulin, which in turn leads to obesity and diabetes. Now, this is a gradual process, so eating processed carbs once in a while is not going to make you gain weight or become diabetic. But if you are eating processed carbs most of the time, then you are at risk. Strive to eat healthy carbs with your meals, but also enjoy your weekend fries at the bar or ice cream with the kids.

Here is a list of healthy complex carbs you can include in your meals:

1. legumes like beans and lentils (probably one of the healthiest and most affordable food sources, rich in carbs, proteins and minerals)

2. whole grains like quinoa, barely and oats.

3. brown rice

4. whole grain pasta

5. whole wheat flour

6. oat flour (great substitute for regular flour)

7. fruits

8. some vegetables like potatoes, zucchini, squash, carrots.

9. whole wheat fresh bakery bread (found at a local bakery, if you have one)

Legumes, quinoa, oats, oat flour, brown rice and pasta are also rich in proteins and fiber, so they can serve as a source of healthy carb and protein for each meal. Fruits and vegetables are rich in fiber but lack proteins.

Here is another benefit of unprocessed carbs: they are rich in fiber. Fiber is a complex carbohydrate that our digestive system can not break down, so it is not absorbed. It enters our body from the top and exits through the bottom. Through its passage in our digestive system fiber acts as a sponge, it absorbs unhealthy food products and byproducts and takes them out. Fiber is associated with lower risk of heart disease, diabetes and it lowers cholesterol. Carbs rich in fiber are whole grains, fruits, vegetables and legumes. On the other hand, processed removes the fiber, so carbs like pasta, white rice, cereals, bread and juices lack fiber.

Here is some common processed carbs you should avoid:

1. white rice

2. any none whole wheat pasta

3. flavored oats (loaded with artificial sugar)

4. cereals (processed carb and loaded with sugar)

5. processed flours (found in pizza, baked goods, pre-made breakfast ingredients such as panckaces and waffles).

6. ALL juices (juicing removes the healthy fiber and concentrates the sugar in fruits).

7. All sodas, regular, diet or zero sugar (high in sugar or even worse sugar alternatives).

8. grocery store breads (most breads are processed with added sugar).

9. ALL those snacks such as protein bars, biscuits, kids snacks and many alike (they all have added simple sugars)

10. and my new favorite is all those flavored "healthy" yogurts and milks (they are all loaded with sugar)

So, try and replace some of your unhealthy carbs with healthy carbs. For most people few simple measures make big differences:

Breakfast:

• replace cereals or flavored instant oats with rolled oats. For sweetness add a little whole milk and smash a banana.

• replace store bought white bread with local bakery whole grain bread or even better, just replace the bread with a banana or any other fruit.

• replace juice with whole fruit.

Lunch & Dinner:

• replace white rice or pasta with brown rice or whole wheat pasta.

• replace rice or bread with quinoa. You can also add quinoa to your salad for a healthy source of carb and protein.

• Most vegetables are rich in carb. Some examples: potatoes, zucchini, carrots, broccoli, corn. One serving is really all you need to fulfill your carbs.

• Add legumes. These can be meat substitutes or in addition, but one serving of any legume like beans or lentils is rich in protein and healthy carbs. (Personally, we have started eating more legumes instead of meat, both for health reasons and to cut costs). If you are new to legumes then be sure to look up some recipes, legumes by themselves are not very tasteful, but with a little herb and sauce, they are surprisingly delicious. And avoid all those flavored canned beans, loaded with sugar. Use raw or pre-made can plain legumes.

Snacks:

• replace all pre-made bars, cookies and kids snacks with fresh Fruits and vegetables. You can always add a little nuts, peanut butter or plain greek yogurt for added healthy source of protein and fat.

You can see HealthierlifeMD recipe page for some examples on how to replace your unhealthy carbs with healthy carbs.