Macronutrients - Carbohydrates

Macronutrients are the nutrients we need in larger quantities that provide us with energy. They include carbohydrates, fats, and proteins, and it's important to find the right balance of these macronutrients to support your unique body. We'll dive into each macronutrient individually, starting with carbohydrates.

What are carbohydrates?

Also known as carbs, this macronutrient provides a primary source of fuel for your body. Carbs include all foods that contain sugars and starches that the body can break down into glucose. Most whole food sources contain fiber, a nutrient that cannot be fully broken down by the body. The main sources of whole-food carbohydrates include:

• Fruits - Contain starches, fiber, and naturally occurring sugars and can be an excellent source of vitamins and minerals.
• Starchy vegetables - Includes beans and other legumes, corn, peas, cassava, and potatoes, among others.
• Whole grains - This includes foods such as brown rice, oatmeal, quinoa, buckwheat, barley, whole­ wheat bread, and pasta.
• Non-starchy vegetables - This category consists of some of the most nutrient-dense options available. Non-starchy veggies include foods like asparagus, greens, broccoli, tomatoes, cucumbers, onions, peppers, and cauliflower.
• Dairy - This category includes milk and other dairy products such as cheese, cottage cheese, or plain Greek yogurt.

These types of carbohydrates are great options to test and play around with to identify the best sources for you.

In contrast, there are several carbohydrate categories we want to limit, including:

• Refined carbohydrates - Refined grains are ultra-processed. During processing, fiber, vitamins, and minerals are mostly removed. Because of this, refined grains are digested rapidly by the body. This can cause rapid rises in blood sugar, thereby increasing glycemic variability. Opting for fiber-rich whole grains may have a more gentle impact on glucose levels as compared to refined grains.
• Added sugars - Found in sweets, snacks/pastries, canned fruits/juices, soda, and other sugary drinks. These do provide energy but are lacking nutrients associated with naturally occurring sugars, such as vitamins, minerals, and fiber. You may see this listed on food labels as cane syrup, dextrose, sucrose, agave nectar, or honey. The American Heart Association recommends no more than 25 grams (6 teaspoons) of added sugar per day for most women and no more than 36 grams (9 teaspoons) for men. However, keeping these as low as possible can have a significant positive impact on your blood sugars AND weight loss efforts. (18)

Carbohydrates, glucose, and weight loss

When we consume carbohydrates, they get broken down into their smallest building blocks, namely glucose. While fat and protein can both be converted into glucose if need be, carbohydrates are the main source of glucose.

Carbohydrates have the greatest impact on glucose and it is normal to have a more dramatic increase in glucose after consuming a higher-carb meal. In a metabolically healthy person, we often see a glucose increase from carbohydrate-containing meals followed by insulin secretion, resulting in 80-90% of that glucose being taken up by our cells for fuel. However, in an insulin-resistant person, we see that there is less glucose uptake in the muscles, leaving more glucose in the blood for longer periods of time. More insulin is secreted to help combat the increased glucose levels which may lead to increased fat storage. A person who can't store glucose properly may have less of an ability to use stored body fat for fuel. (17, 19, 20)

Remember that when we spend most of our time in a healthy glucose range, our bodies are more likely to tap into fat stores. When we discover our personal tolerance to carbohydrate-rich foods, it can help us lessen the degree of glucose and insulin spikes. Focusing on adjusting meals with the lowest overall meal scores may be a helpful strategy to promote fat loss.

 Your response to carbohydrates is highly individual and multifactorial. While a lower-carb diet may be suitable for one person, someone else may respond better to a more moderate-carb intake. With the help of the CGM and glucose monitoring, we are able to test and discover the carbohydrate threshold that works best for your body. We recommend consuming your normal diet and carbohydrate intake to start, and then adjusting intake based on your glucose responses. If you're having higher responses to meals containing carbohydrates, reducing the carb content by 15-30 grams per meal can be a helpful place to start. Your nutritionist can help you with a personalized plan to find your carbohydrate threshold. (21)

Quality matters

While there are no "good" or "bad" carbs (food doesn't have a moral designation), it's important to limit ultra-processed foods and added sugars for weight loss and better glucose control. The lack of fiber and nutrients combined with a high amount of added sugar can negatively impact overall health and weight loss progress.

Eating an abundance of ultra-processed foods can lead to:

• Glucose instability, which may promote inflammation and may increase the risk of chronic disease
• Fatigue and low/fluctuating energy levels
• Increased cravings
• Poorly regulated hunger cues
• Anxiety, depression, and/or mood swings (22, 23, 24)

To avoid the above, we recommend limiting the following foods::

• Soda/pop
• Fruit juices
• Cakes, cookies, pies, pastries, ice cream, chocolate, cupcakes, muffins, etc.
• Sugary cereals like Frosted Flakes, Honey Nut Cheerios, Fruit Loops, etc.
• Processed starches such as trench fries, white bread, battered/fried foods
• Snack foods such as chips, crackers, and energy bars

These changes don’t have to happen overnight, and small swaps can make a big impact! A few simple food/drink swaps to consider include

• Replacing your favorite soda with a lemon and lime-flavored Zevia or carbonated water
• Replacing a high-sugar cereal with steel-cut oatmeal sweetened with mon fruit or allulose sweetener
• Replacing white bread with sourdough or Ezekiel bread on your sandwich
• Opting for fresh fruit instead of a cookie.

The options are endless, and your nutritionist can help suggest swaps that will be most impactful for you.

A note on fructose

Fructose is another type of simple sugar, similar to glucose, and it has received attention from health
experts in recent health experts in recent years. Carbohydrates that contain fructose include fruit, agave, honey, and foods high in high fructose corn syrup (HFCS). While fructose itself can be a healthy part of a balanced diet, excessive fructose intake may negatively impact metabolism and weight loss efforts. (25)

So what makes fructose different? While glucose goes through several different metabolic regulatory "checkpoints" in the bloodstream, fructose is absorbed by the body differently and is metabolized directly in the liver. Excess fructose consumption may lead to excess fat accumulation and an increased risk of non-alcoholic fatty liver disease (NAFLD). NAFLD has been shown to reduce insulin sensitivity and decrease glucose tolerance. (26)

For most people, fructose from whole food sources like whole fruits (not fruit juice!) can be a part of a balanced diet. However, individuals with insulin resistance may want to further restrict fructose intake. As a general rule, limiting foods high in refined sugars and HFCS is an excellent strategy to support a healthy lifestyle and weight loss success. (25, 26)