Insulin resistance
Confused about carbohydrates? A quick guide to the carb spectrum
by Marcelle Pick, OB/GYN NP
For most of us, our relationship with food is a rather intimate one. There are times
in our lives when food comforts us, makes us feel loved, or makes us giddy with
pleasure. But it’s also possible that some of our favorite foods would not
be considered good for us. Understanding why that might be true can help us learn
to love healthier foods that fully nourish both our souls and our bodies. This is
particularly true of carbohydrates, a vast and important food group that can be
difficult for women to negotiate.
A few years ago, the phrase “good carb, bad carb” became popular in
nutrition circles, largely due to the publication of a book under this name. These
buzz words have had the unfortunate effect of implying that women themselves
are good if they choose a “good” carb like fruit, or bad if they choose
a “bad” carb like cake. The truth is that most foods have something
to offer us, and a piece of cake just might be “good for you” at a certain
moment because it provides comfort, familiarity, or pure satisfaction. And enjoying
a traditional sweet during the holidays is harmless enough, unless special occasions
become an excuse to overindulge.
Carbohydrates cannot be systematically divided into white hats and bad hats. The
carbohydrate spectrum is a wide one — containing foods as diverse as green
beans and high-fructose corn syrup! The spectrum is so wide because some carbohydrate
foods are so much more nutritious than others. Understanding how different carbohydrates
break down in the body is not only helpful in preventing insulin resistance and
managing your weight, but can also help you optimize the effects of the food you
eat and limit sugar cravings.
What is a carbohydrate, anyway?
You may think that all carbohydrates are starchy and sweet, but in fact, there are
carbs in many types of food, including grains, fruits, vegetables, and sweets. As
the word itself suggests, carbohydrates contain carbon, hydrogen, and oxygen. Their
basic function is to fuel our bodies’ energy needs. Carbs are fundamental
nourishment for humans, and the brain is especially dependent on a steady supply
of the glucose (simple sugar) we get from carbohydrates. In fact, brain cells can
only use glucose to create the energy needed for brain function.
What do glycemic index and glycemic load have to do with it?
The effects of carbohydrates on the body are factored into what’s known as
their glycemic index (GI). The
glycemic index is a scale that ranks foods numerically according to their potential
for increasing blood sugar (blood glucose) and insulin levels. Those foods with
a high GI increase blood sugar rapidly, while those with a low GI increase blood
sugar more slowly.
While this measurement gives you a preliminary sense of the impact a certain food
might have on your system, the more important — and more practical —
number can be found in the glycemic load (GL) of a food. Glycemic index calculates
how quickly the carbs in a particular food are converted into sugar in the blood,
whereas the glycemic load factors serving size into the equation, as well as protein
and fat content, to give you a better sense of how much sugar your cells will likely
take in, and how fast, when you eat that food.
This is an important distinction, because there is no one-to-one correlation between
the amount of carbohydrate in a food and its effect on blood sugar and insulin levels.
In other words, the glycemic load is more of a qualitative than a quantitative measurement:
it rates not just how much carbohydrate is present in the food, but also what kind
of carbohydrate you’re eating, as well as how much of it you consume.
To give you a general idea, carrots and plain macaroni have the same GI, but they
don’t have the same GL. The macaroni contains mainly refined starchy carbohydrates
that break down quickly in the body, while carrots have complex carbs that break
down slowly — as well as a higher fiber content, which also affects how quickly
the carbs break down. (They’re also rich in vitamins and antioxidants, unlike
white macaroni.) So although you can eat portions of both foods that contain the
same amount of carbs, you won’t get an identical release of insulin —
carrots just don’t break down as quickly as macaroni, so the body isn’t
flooded with glucose.
As noted above, quick breakdown of carbs means a more rapid influx of glucose into
the bloodstream, which in turn sends insulin spiking upwards. The higher and more
often insulin spikes, the more likely your cells are to become resistant to its
action. In short, the higher the glycemic load of a food, the greater the tendency
for that food to cause insulin spikes and to potentially affect your metabolism.
To learn more about the differences between these two nutritional tools, see our
page on the glycemic index and glycemic
load. As a dietary rule of thumb, it is far more useful to gain a sense
of the glycemic load of different foods in order to make realistic choices about
what and when you plan to eat, and how those choices affect your insulin response.
Mendosa, D. 2008. Glycemic index and glycemic load. URL: http://www.mendosa.com/gilists.htm
(accessed 11.13.2008).
Mendosa, D. 2003. Glycemic values of common American foods. URL: http://www.mendosa.com/common_foods.htm
(accessed 11.13.2008).
Instead of the either-or thinking of “good carb-bad carb,” let’s
talk about carbs in more graduated terms: “refined” or “complex.”
(In biochemistry, they’re classified according to how big their molecules
are and how soluble they are — see Table 1.)
Descriptions reflecting a spectrum rather than distinct groups are more useful because
many foods fall somewhere in the middle range.
As a rule of thumb, the more fiber, micronutrients, and macronutrients your carb
choice contains, the better it is for you. More stuff, or “information,”
makes it a more complex carb; less stuff means it’s a refined, or simpler,
carb. Refined carbs break down easily and are quickly transformed into the simple
sugar glucose, so they give us a quick burst in blood sugar, causing sharp insulin
spikes. Complex carbs take longer to break down and produce a more moderated insulin
surge and gradual decline.
As their name implies, refined carbs are the result of processing carbohydrates
into a different form — one that often has a powerful effect on the body.
White sugar and white flour, for example, are refined carbs found in cookies, pasta,
and white bread. These carbohydrates have developed a negative reputation for several
reasons:
- They are metabolized quickly and lead to insulin spikes in the body. Foods that
contain them tend to include very high amounts, so the insulin spike is generally
fairly sharp. Continual high spikes in blood sugar and insulin can damage metabolism,
contribute to insulin resistance, and, as most of us know already, cause weight
gain.
- Refined carbohydrates are considered by some practitioners to be addictive because
eating them generates an immediate and measurable spike in serotonin, the
chemical neurotransmitter in the brain responsible for mood, appetite, and some
behaviors.
- In the refining process, complex carbohydrates are stripped down to their most basic
components, so they no longer contain micronutrients we need for healthy day-to-day
cellular function — they’re missing the nutrient “information”
your body needs. Apart from what they’re missing, baked goods, breads, soda
and other sweets made with refined carbohydrates often do contain unhealthy additives
like high-fructose corn syrup
and trans fats.
- Refined carbs can “spoil your appetite.” Whether it’s a supersized
box of jujubes at the movies or drinks during a prolonged cocktail hour, refined
carbs are generally sky-high in calories, so they tend to displace more nourishing
foods in the diet.
At the other end of the spectrum are complex carbohydrates like vegetables, fruits,
whole grains, legumes, and nuts. Complex carbohydrates enhance our health in the
following ways:
- They are typically rich in both fiber and micronutrients, offering real nutrition
that the body needs to function.
- This added nutrition takes longer to digest, and the slower break-down process helps
maintain healthier insulin and blood sugar levels, keeping moods on a more even
keel and diminishing risk for insulin resistance.
- The slower rate of absorption of the sugars they provide means we have a steadier
supply of energy and results in less sugar being converted into storage forms in
the liver and as fat.
- Slow-acting, complex carbohydrates also satisfy hunger better and for longer periods,
limiting the dramatic peaks and troughs — and the vicious cycle of cravings
— we experience with simple carbohydrates.
Making good carbohydrate decisions
Many women might think it’s best to simply cut out all carbohydrates, but
such a radical maneuver isn’t necessary — and it isn’t healthy,
either. We all need carbohydrates to maintain wellness and fuel brain function.
We recommend choosing carbs that will satisfy your hunger and desire to eat something
tasty while giving your body the nutrition it needs.
Here’s a basic chart to give you some idea about foods that have a quick effect
on blood sugar versus those that are gentler on your metabolism. Remember, this
is just to give you a rough idea; in reality there are dozens of factors influencing
their effect. As a general rule, we always advocate for the foods that are the least
processed and the most naturally rich in nutrients. When selecting carbs, note that
portion size does matter. You can eat generous amounts of slower-acting carbs —
especially wonderful when you are concerned about satisfying hunger for longer periods
— or smaller amounts of fast-acting carbs, particularly if you just want a
taste of something sweet.
Fast-acting carbohydrates
|
Intermediate-acting carbohydrates
|
Slower-acting carbohydrates
|
|
Cookies
|
Fruits
|
Whole brown rice
|
|
Cakes
|
White potatoes
|
Quinoa
|
|
White bread
|
Sweet potatoes
|
Millet
|
|
White pasta
|
Carrots
|
Sprouted grains
|
|
Sugar cereals
|
Beets
|
Other whole grains
|
|
Juice
|
Winter squash
|
Milk
|
|
Alcohol
|
|
Nuts
|
At Women to Women, we encourage women to follow the “85-15 guideline.”
This means maintaining a nutritious and balanced diet 85% of the time. The other
15% is up to you. When and if you do decide to indulge — which we all deserve
from time to time — follow these tips to prevent the “carb crash”
many women experience after eating too many sweets.
- Pair your treat with some protein and a little fat. Eating some nuts with your cookies,
or a piece of cheese or some other protein, will slow down digestion and lower the
insulin spike.
- Choose cookies or cakes that already contain whole grains and nuts. This makes pairing
your sweet with protein easy! You might also consider flourless recipes for baking,
some of which are traditional in other countries. They’re still delicious
but, unlike most cakes and cookies, don’t call for flour.
- Go for dark chocolate (preferably 60% cacao or higher). Dark chocolate typically
contains less sugar and provides lots of antioxidants too.
- Take your time. If you are treating yourself, take the time to enjoy the experience!
Become aware of your sweet’s appearance, its aroma, and its taste and texture
on your tongue. We are all likely to be more satisfied when we slow down and become
more aware of the sensual joys of eating.
- Have a tall drink of water or mineral water with a slice of lime or lemon before
and after your treat — especially if it’s a celebratory libation! There’s
a lot of wisdom in the adage, “Mix some water with your wine.” Quenching
your thirst can be surprisingly satisfying — you may even find that your carb
cravings abate or disappear.
- Remember, if you’re insulin resistant, a little goes a long way! You may have
trouble with any kind of carb, so choose wisely and enjoy fully.
Don’t let carbohydrates get you down
Learning some basics about carbohydrates will allow you to make informed decisions
not just on ordinary days, but the next time you’re at that holiday party
or birthday celebration, so you don’t end up feeling guilty or deprived.
The take-home message is that your body needs the information contained in complex
carbs to maintain health and to regain insulin sensitivity. Without that information,
you may be creating conditions that accelerate disease processes. Complex carbohydrates
usually contain macronutrients like protein and healthy fats, plus essential micronutrients
that are key players in maintaining a healthy metabolism. They offer the slow-burning
fuel that allows you to feel sated, and help your body regulate insulin production
and release.
Simple carbohydrates have been labeled “bad” because of the way the
body metabolizes them. But that doesn’t mean you are bad for eating them!
These treats are desirable for a reason, and depending on our circumstances, we
have to make the decision that’s right for us in the moment. It’s true,
too much sugar on a regular basis can cause rollercoaster moods and energy “crashes”
that can spin you into a vicious cycle of hard-to-manage cravings. But it’s
always best to strive for balance. So by all means, treat yourself every now and
then, but don’t let carbohydrates get you down!
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements,
our exclusive endocrine support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
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Related to this article:
References & further
reading on confusion about carbohydrates
Original Publication Date: 12/01/2008
Last Modified:
02/16/2010
Principal Authors: Marcelle Pick, OB/GYN NP