Lets overcome Carbophobia

Diets and dieting is a theme that has received a great deal of public attention. People have made their body as an  experimental tool for trying different “TRENDY” diets to achieve weight loss or for their perceived health benefits.

CARBS have been made “nutritional villain” and there  is increasing reliance on diet containing fewer carbs.  

People often think consuming carbs will lead to  weight gain (I loved this awesome picture posted by  my dietitian friend with mug saying-“You would be  nicer if you ate carbs”) . Besides, obesity is a sensitive  and stigmatized topic and eating habits have become  an increasingly important means of social and  personal evaluation and devaluation. Those who  succeed are seen as morally superiors.

Given the complexity of energy regulation, it is unlikely that one, single component of the diet causes obesity. Nonetheless, several myths persist in this area. Lets delve into understanding the carbohydrates.

Carbohydrates and their role in human body

Carbohydrates are molecules composed of carbon, hydrogen, and oxygen. Carbohydrates are made up of one or  more units of simple sugars. According to the number of sugar units, they are classified as simple sugars  (monosaccharides and disaccharides), complex carbohydrates (the poly saccharides), most dietary sources of fiber, and alcohol sugars.

When we talk about storing and burning carbohydrate, the ‘common energy currency’ used by the body is GLUCOSE. 

The primary role of dietary carbohydrate is the provision of energy to cells, particularly the brain that requires  glucose for its metabolism. Other nutrients (eg fat, protein and alcohol) can provide energy but there are valid reasons to limit the proportion of energy provided by these nutrients. 

Stored carbohydrate, in the form of glycogen, provides a short-term energy reserve for bodily functions. 

Human body needs a reliable source of carbohydrate for the normal functioning of our brain, kidney medulla, red  blood cells, and reproductive tissues. The brain alone accounts for 20–25% of adult basal metabolic expenditure. In  addition to the demands of the brain, red blood cells re-quire approximately 20 g glucose per day directly from the  bloodstream(5). 

Why Carbohydrates are an integral component of a balanced diet:

Main source of readily available energy for the body

  • Supply carbon atoms for the synthesis of other biochemical substances (proteins, lipids, and nucleic acids). • Form a part of the structural framework of DNA and RNA molecules 
  • Regulation of blood glucose and prevention of ketosis 
  • Carbohydrates linked to lipids are structural components of cell membranes. 
  • Carbohydrates linked to proteins function in a variety of cell–cell and cell–molecule recognition processes as  useful markers for antibodies. 
  • Glucose is the main energy source for fetal growth, and low glucose availability can com-promise fetal survival
  • Crucial macronutrient to enhance sports performance (main fuel used in exercise that lasts for an hour or  more, builds fuel reserves, delays fatigue and improves recovery)- Many of the fitness anthusiasts I come  across say that they need more protein to build muscle and undermine the power of carbs. 

Carbs have a protein sparing effect i.e. having adequate carbohydrate in your diet protects muscle tissue from being  broken down and used as energy. It ensures that any protein consumed is used for their primary purpose (muscle  growth and maintenance) rather than being redirected to perform the function of the carbohydrates. Talking about  the importance of carbohydrates, apart from its direct benefits, there is also an added advantage of carbohydrate  consumption i.e. carbohydrates are found in different foods, which if eaten, also pave way for consuming other  essential nutrients. Therefore, it is preferable to go in for distinctive carbohydrate food sources.

The primary reason why carbs are defamed is due to  today’s foodscape laden with energy-dense and  processed foods (categorized as discretionary foods), which have led to the reduction in intake of wholegrain foods. Energy-dense foods are rich in refined carbohydrates and unhealthy fats. Snack-food items and soft drinks make up the majority of energy dense foods, while energy density is low in fruits and vegetables, poultry, fish, and whole grains. Due to such dietary changes, obesity is becoming a major health concern worldwide alongwith other associated diseases.

What does the research say about carbs and its relation to weight?

People consuming more energy-dense foods and less whole grains are more likely to have higher BMI than those  doing otherwise. A study by Bugge, 2015 found that participants were least likely to be overweight or obese and had  lowest BMI if they consumed between 47% and 64% of calories from carbohydrates. Participants consuming more  carbohydrate ate more fruit and vegetables, fiber, and less saturated fat than those consuming less carbohydrate. 

Although such diets may elicit improvements in TG and HDL-C levels, glycemic control, short-term weight loss and  reductions in diabetes medications, but have variable effects on LDL-C levels; however, by approximately 2 years,  there are no differences for most cardiometabolic risk markers. The study provides compelling evidence that low and very-low-carbohydrate diets are not superior to other weight loss diets and that adherence to the severe CHO  

restriction of very-low-CHO diets is challenging with the potential to cause adverse side effects and increased all cause mortality(6). 

Merchant et al reported a similar finding and revealed that carbohydrate intake was inversely associated with risk of  overweight or obesity in this sample of free-living, healthy Canadians. Lowest risk of overweight or obesity was  found among those consuming between 190 to 310 g/day carbohydrates (equal to between 47% and 64% calories  from carbohydrate). Individuals with higher carbohydrate intake ate more fruits and vegetables and fiber, and less  saturated fat, and a higher percentage reported being physically active, than those consuming less carbohydrate. The study concluded that the inclusion of whole grain instead of refined grain, more fiber, less saturated fat, fewer  calories and physical activity have numerous benefits.

Reynolds and colleagues explains how altering the quality of carbohydrate intake in randomised controlled trials  affects non-communicable disease risk factors and how these changes in diet quality align with disease incidence in  prospective cohort studies. This alignment is seen beautifully for dietary fibre intake and whole grain intake, in which  observational studies reveal a reduction in all-cause and cardiovascular mortality, which is associated with a  reduction in bodyweight, total cholesterol, LDL cholesterol, and systolic blood pressure reported in randomised  controlled trials.  

What’s your gut feeling about carbs? Carbohydrate restriction for low-CHO diets and very low-CHO/KDs are also of  concern for gut health due to the avoidance of CHO-rich foods that provide dietary fiber for the gut microbiome(3). 

According to NHMRC Nutrient Reference values, the recommended acceptable macronutrient distribution range for  carbohydrate intake in adults and children is 45–65% of dietary energy intake (FNB:IOM 2002). 

In nutshell, the type of carbohydrate can markedly influence energy density of the diet and subsequently on the  body weight. Having said that, it doesn’t mean you avoid your favourite donuts, waffles, ice-creams, pretzels or your  French fries. Since these are discretionary foods, these can be consumed ocassionally, taking care of the portion size.

Key messages: 

✓ Most of the carbohydrate should be sourced from low energy-dense sources such as wholegrain cereals,  vegetables, legumes and fruits, which are mostly low glycaemic index foods and with good fibre content. ✓ Minimise consumption of added or simple sugars to avoid chronic disease risk and weight gain. ✓ Where possible, consume the edible peel of fruits (skin of apple, kiwi) and vegetables (eg.potato, sweet  potato, pumpkin) 

✓ Switch from refined varities to wholegrain ones 

✓ Moderation is the key to good health. Adopt a healhy eating pattern by following a balanced diet (not  overdoing/cutting off on any macronutrient) and indulge in regular physical activity.

Our Director
Purva Gulyani

Purva Gulyani – an Accredited Practising Dietitian and lifelong member of the Indian Dietitian Association. Currently pursuing PhD at Latrobe University. Purva brings over 16+ years of clinical dietitian experience to the table.

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