Earning Your Carbs

[barbara-cook]

My husband was put on cholesterol medication recently. The nurse practitioner told him that he had to "earn his carbs". We have been "cooking light" people for about 10 years now and while we occasionally splurge, we TRY to eat right.

He's telling me that we should stay away from pasta, rice, bread, etc., and I know they are all high carb foods. However, the Cooking Light food guidelines show that he should be able to manage 410 g of carbs a day, while I should be able to managed something like 300 a day. We have whole grain cereal for breakfast, whole grain bread for sandwiches, brown rice as opposed to white, and generally try to limit pasta to once a week or less.

Now of course, I'm looking at the nutrition labels for the g's of carbs. Those numbers above seem high (or they seem like we couldn't be eating too many the way we eat) so I'm a little confused.

My husband has a desk job - but he hikes up 4 flights of stairs to his office. He works out at the gym 3-4 times a week (elliptical and treadmill) and burns about 700-800 calories each time. I on the other hand, go to the gym about 5 times a week, do about 45-50 minutes of cardio (bike, elliptical and treadmill) along with 45-60 minutes of circuit training 3 times a week. My cardio calorie burn is usually around 500 calories.

We're both 53 and while we do these workouts, we could both stand to lose 10-20 pounds. His downfall is snacks and mine is more or less eating a little more than I should. I've been really trying to cut back and have lost a few pounds since the beginning of the year, so I feel like I'm on the right track. But I really want to be able to help him "earn his carbs".

So two questions: are we earning our carbs?
And other than cutting out pasta, rice and bread completely, how else can we trim our carb intake?

I'm not looking for a science lesson, just some good advice.

[wallycat]

As we get older, our bodies have a harder time processing carbs (glucose intolerance--IGT). Some folks can be skinny and still have the issue as this can be a genetic issue.

Most people will show a glucose response with 15-20 grams of carbs per meal.
You may want to look at www.glycemicindex.com and this may explain better how different carbs affect our glucose response.

Is your dietitian suggesting that you burn the calories of the carb amount you consume or is she suggesting you exercise fairly soon after ingesting a carb to regulate how high the blood sugar will spike?

Cooking light, IMHO, is becoming passe...it isn't as important to limit fat as it is to limit "BAD" fat.
Calories are calories and people can get fat or lose weight depending on how many calories (fat, carb, protein) you consume versus how many you expend (exercise). The only bad thing about people who are sensitive to carbs is that any great elevation will start with a large insulin dump. The insulin forces your body to start storing calories as fat reserve. This is why some people are much more successful on Atkins or Southbeach.

Feel free to PM me if you have specific questions.

[barbara-cook]

Wallycat: Thanks so much for your answer. I went to the website you provided and it does answer a lot of questions. I signed up for the newsletter, and put one of their cookbooks on my wishlist at Amazon (so I don't forget about it).

After reading more on this site, and giving it some thought, I think for us it may be more or less portion control and being more careful about snacking, along with using more of the good fats.

The physicians assistant didn't really give my husband much more information about "earning the carbs", other than increasing his workouts and doing what I mentioned in the last paragraph. During the winter months we are far too sedentary so the gym becomes a necessity. Once warmer weather arrives, I am out gardening every day (it's my job!) and he gets in several rounds of golf (walking) each week.

I have had success in the past with counting calories and measuring what I eat, keeping a daily log, etc. And we are currently participating in a daily log with our health insurance provider, so we are watching what we eat and being accountable for it, along with our workouts. So that does help give us incentive.

Just another thank you for your response and the website and pointing me in the direction to get more answers! I know I could count on the message board community to give me a little guidance!

[wallycat]

My pleasure!

I asked the question about the intent of earning calories because I have had diabetes patients who did not want to go on insulin/meds right away and since they were retired, they walked or used the rubberbands in the house immediately after eating.
This burns the glucose off and helped manage their blood sugar without meds. In a way, that is earning your carbs.
Not everyone can exercise right after they dine though.

Things like acidic foods (lemon/vinegar based salad dressing),
cinnamon,
fiber
all help blood sugar from spiking.

There are many low-carb foods that are fairly healthy (I wouldn't include too many fake things).
La Tortilla makes a decent low-carb tortilla using soy flour,
sprinkle cinnamon on fruit and eat it for lunch or after dinner as a dessert. Breakfast is the hardest time to manage glucose for most people.
Rye seems to help folks with insulin sensitivity, so maybe a whole grain rye bread instead of regular whole wheat.

Best to you!

[Valerie226]

wallycat, can you explain in a little more detail about why atkins and southbeach don't work for some?
I remember my first try at atkins. after about 3 days I was so hungry I was weak. eating chunks of cheese, and pieces of fish seemed to make me hungrier. when I checked my blood sugar it was in the mid 50's, I was dizzy, sweating. I ate a soda cracker and felt better in seconds. so much for Adkins... I've stayed with a pretty carb heavy diet since, good carbs though.

now I have a younger brother & sister who both have T2.

[wallycat]

wallycat, can you explain in a little more detail about why atkins and southbeach don't work for some?
I remember my first try at atkins. after about 3 days I was so hungry I was weak. eating chunks of cheese, and pieces of fish seemed to make me hungrier. when I checked my blood sugar it was in the mid 50's, I was dizzy, sweating. I ate a soda cracker and felt better in seconds. so much for Adkins... I've stayed with a pretty carb heavy diet since, good carbs though.

now I have a younger brother & sister who both have T2.

I can't assume I know exactly what happens, but this is my logic:
most people who have glucose impairment have problems not only dumping out the proper amount of insulin (pancreas) but also glycogen stores (muscles/liver).
Some people have high fasting glucose values (liver issue) and some people's pancreas overcompensates when they consume carbs and overshoots, which causes reactive hypoglycemia.
This can happen as separate events or combination of events.

So a few examples: You are not eating enough calories and your liver/muscles will try to provide glucose to ensure brain support. In some people, this happens only at near starvation, but we are talking impaired carb/sugar functions.
If you eat things like cheese and vegetables, though they may not be high in carbs, they still contain carbs. You may be getting reactive hypoglycemia from that.
Some studies also show that hyperinsulinemia occurs when cheese/dairy is consumed; this could pose too much insulin and have the same effect as reactive hypoglycemia.

South Beach and Atkins work on the principle that insulin output forces cells to store circulating glucose into fat cells. Thus by eating lower on the carb scale, less insulin is dumped out, thus less fat storage.....but as you can see, how much insulin we produce can be altered even by a few carbs. This is why Atkins insists on such a strict phase 1.

Add to this thyroid/metabolism/muscle ratio to body fat, and weight loss can be difficult even with lower insulin values.
Calories do count...Atkins counts on the fact that protein and fat make you feel full faster/longer so you eat less, but again, how hungry you get adds up to more than just how much or type of food you consume.

Hope this helps.

[Valerie226]

Hmmm.. I know that the theory is fat and protein make you feel full longer but in my experience not strongly. but I eat almost exclusively complex carbs. I'm not overweight like brother/ sister, both have poor diet and exercise habits but anything going on in close relatives bears watching.

Back when I tried Atkins.... never got past the first phase.. we did urine checks for ketones. if I ate a piece of iceberg lettuce I stopped dumping ketones. I remember the people I was working with were doing the same diet and they could eat tons of vegies and they kept producing ketones. we worked for a company producing urine test strips so we really weren't weird comparing urine test results. my blood sugars are normal, weight normal, I exercise a lot. I still worry because T2 is so blasted common. I'd never do a low carb diet again ( I'm mostly vegetarian) because it made me feel so awful and most of what's on it I don't eat, but it sure is strange how different the reactions to the diet are. I know/knew people who do well on it.

[wallycat]

You are smart...it does bare to monitor and be mindful because family shows what is possible, but it isn't guaranteed.
No one in my family had cancer....and I was the "lucky" one...

I had a BMI of 19, exercised 2-3 hours daily and was dx with a high fasting blood sugar (prediabetes). My twin is overweight, doesn't do much exercise, is on BP meds that can predispose someone to diabetes, and her fasting is 84. Go figure.

I am trying to low-carb but honestly, I do it because I have horrible reactive hypoglycemia and I hate how it feels.
I can honestly say that even though I exercise, I don't really show any weight loss. It could be the cancer meds I'm on (put me in menopause and we know what THAT does to the body) or just getting older---I'll be 53 in May.
I am not NO carb...but am very selective.

WOW on the iceberg lettuce and ketones...it sounds like you are VERY sensitive to processing carbs.

I will say that fasting glucose is not as predictive of diabetes as people (docs/RDs) presume it is. I always ask for an A1C and that tells me more of what my body is doing after I eat.
I have a glucose monitor that I used when first dx with prediabetes so I could see which foods did what to my glucose.
We are all individuals...my DH, who is 17 years older than me, can eat jam and bread and carbs and never move out of the 90-100 range. If I eat 4 potstickers, I will be in the diabetes range. I'd never have known that if I didn't check with the monitor.
I assume at some point I will become diabetic, but the longer I can stave it off, maybe newer, better drugs will be available.

[Valerie226]

My mother got breast cancer... first person in our family to get any kind of cancer, so I somewhat understand your situation....and it's not fair! Ah yes, menopause... that was such a pleasant time.
quite a few in our family have T2 along with obesity and sedentary living. My brother was mid 40's but wasn't formally dianosed for several years. Didn't matter, he pays no attention to diet, exercise or testing anyway. sister always was obese but had (long ago) gastric bypass/stomach stapling procedure... supposed to be preventive for T2. she didn't lose much weight. she was recently diagnosed at 58. It's sad .. all of their children are setting up for the same, all overweight, eat junk, and don't get any exercise. Nobody listens though, I might as well be talking to the cat.

My fasting sugars are normal and only had the hypoglycemic episodes trying low carb diets which piqued my curiosity. I keep a meter around and check sugar twice a year to reassure I'm not going down the same road.

[vbak]

What is the diabetes range that you spoke of after eating pot stickers? I am unmedicated, and i have no idea what i should be putting in mouth to control my blood levels. Daytime is fine, well breakfast and lunch, but the morning is not so good. Sometimes it's in the 140s and lately it has been in the 120's. The dr. wants it -110. I had a morning reading of 106 when we were in Germany for Christmas after eating pasta with a heavy creamy mushroom sauce[so delish but I didn't eat all of it], wine, and two ciabatta brotchen with butter. I DON"T GET IT!!!

Sorry to hi-jack. I never come to this site, and by accident i did today. If you have any advice...

Vicky

[wallycat]

Fasting (when they draw your blood) should be under 126.
Over 126 FASTING is considered diabetic. Fasting "good" numbers are now UNDER 100. Prediabetes is 100-125.

If you have random value 200 or higher on TWO occasions, it is indicative of diabetes.

Fats/proteins and especially alcohol bring down the glucose with relation to the carbs you are eating....so a pasta with cream sauce plus wine....and pasta gets a bad rap; even "white" pasta is considered medium on the glycemic range, not high, like white bread. Actually, finely milled whole wheat bread has the same glycemic index as white bread.

Mornings/breakfast are typically harder because not only are you eating, but your body (liver) is trying to provide you with glycogen for energy. Add to it that Americans are obsessed with cereals for breakfast (usually boxed flakes), which has a high glycemic index.....a disaster waiting to happen.

Valerie, I had to laugh....talking to the cat!! HAHAHHA, MY cats listen to me; My sister does not. I feel your pain.
It is very frustrating to find people who abuse their bodies with what they eat and come out unscathed, but I feel like I owe it to myself (and my profession) to make wise choices---let the chips fall where they may!

[Valerie226]

Sadly, it's true... my cat pays more attention than my brother and sister! my cat is also nicer and more polite and will probably live longer ... Not much can be done with people who refuse to see reality.

[vbak]

It is funny Valerie, but I think my dear sweet cat had diabetes.:(

Anna, I have never had a fasting level of 200 or more. My last A1C[two weeks ago] was 6.4, up .5 from October, and I've gained 3 lbs. It was 118 the morning of the draw. My sugar, as I type is 105. I don't want to go to the dr. next month, in fact I haven't even made the appointment yet.

According to my lab report, on 2-22, the new numbers for A1C will be 4.8-5.6%.
Increased risk is 5.7-6.4, and and diabetes is +6.4. Glycemic control for adults is -7.0.

So depending on when you had the test you may or may not be diabetic? Does the medical world/pharmaciutical [sp?] companies want everyone to be on medication?

I hate this!!:( I REALLY enjoy eating.

Vicky

PS- I HATE cereal for breakfast! I like eggs and...
Today it was tuna salad om low cal high fiber bread.

[wallycat]

It is funny Valerie, but I think my dear sweet cat had diabetes.:(

Anna, I have never had a fasting level of 200 or more. My last A1C[two weeks ago] was 6.4, up .5 from October, and I've gained 3 lbs. It was 118 the morning of the draw. My sugar, as I type is 105. I don't want to go to the dr. next month, in fact I haven't even made the appointment yet.

According to my lab report, on 2-22, the new numbers for A1C will be 4.8-5.6%.
Increased risk is 5.7-6.4, and and diabetes is +6.4. Glycemic control for adults is -7.0.

So depending on when you had the test you may or may not be diabetic? Does the medical world/pharmaciutical [sp?] companies want everyone to be on medication?

I hate this!!:( I REALLY enjoy eating.

Vicky

PS- I HATE cereal for breakfast! I like eggs and...
Today it was tuna salad om low cal high fiber bread.

200 is for the 2 random checks. Over 125 (126+ at fasting) is considered diabetic.
I know that "pre" conditions have become more popular...some people think it is a great warning so that those who care can become mindful. Others say it is a way to sky-rocket your insurance and it really doesn't do much to help the patient.
Docs won't put you on meds in any "pre" status: pre-diabetes, pre-hypertension, etc...
Most docs/RDs want (for diabetic patients) to be under 7 for A1c. If that requires meds, than that is what they will suggest.
If you can keep it under 7 with diet/exercise, they will usually say fine.

I wish they would find a cure for diabetes as it appears, from all the studies I've read, that those of us prone to type 2 are just genetically blessed to survive feast/famine.....We are just "lucky" enough to be in feast mode most of our lives.

[Valerie226]

Interestingly some folks who get the "pre diabetes" dx get motivation for the first time, to stick to a diet/weight loss/exercise program. It's possible to reverse the situation but of course the new habits have to stick. I understand it's not possible for everyone but it is possible for many. whoops... gotta finish this later...

[Valerie226]

Wanted to add that my previous kitty had diabetes brought on by cortisone. he had asthma and needed to get a shot every couple months when the asthma flared.. could not pill this cat at all.. and he developed diabetes and died shortly after. he was an old guy but we loved that little guy,. he had such a great personality.

[vbak]

Checking back in Valerie, and i read the post about your special guy. Our girl was special, too. She had a wonderful personality; she loved people and snuggling up with them. She's been gone along time, but sometimes I can still feel her snuggling around my feet when I'm stretched out on the couch.:(

Anna, I have not had cereal and a piece of toast all week, and my sugar has been in the low 120's every morning. I have also not eaten any school food for breakfast[ a half Eng. muffin, or a sausage pattie, and my all time favorite breakfast pizza, 2 slices]. One morning this week it was 118. I was so happy. Thank you for your time and advice.

Vicky