Wednesday, June 29, 2016

Why Going Low-Carb is NOT the Best Idea

Have you been told by a medical professional, friends, family member or even a figure on the Internet that you should be following a low-carb diet for Diabetes or weight-loss? This is something I hear from clients quite frequently. With my experience in counseling and also the research, I am here to tell you that it is perfectly okay to eat carbohydrates if you have Diabetes or want to lose weight. Shocking, I know! Below are the top 4 reasons I have for not following a super low-carb diet based on the majority of things I hear from clients. 

1. Low-carb means no fruit!
One of the first things people tend to do when cutting carbs is cutting the fruit out! Fruit is packed fiber, vitamins, minerals and antioxidants; even those “deadly” bananas! I don’t know how many people come to me with Diabetes saying they can’t eat fruit. Let me just say that when I look at the food diaries of these patients, most are not overeating the fruits. Aim for whole fruit over juices and eat the skin if possible since that is where a lot of the nutrients and fiber lay. Just see below at just some of the research touting the benefits of fruits and vegetables! 
 ---->“In Chinese patients with Type 2 diabetes, higher dietary fruit intake was associated with a lower burden of carotid atherosclerosis as reflected by lower carotid intima-media thickness and prevalence of carotid plaque.”1
 ---->“Fruit and vegetable intake may decrease oxidative stress and inflammation in this group of patients. An increased intake of fruit and vegetables can therefore be beneficial for patients with type 2 diabetes, since these patients are documented to have raised oxidative stress and inflammation.”2
 ---->"Plant-based diets, especially when rich in high-quality plant foods, are associated with substantially lower risk of developing T2D."3

2. Food quality is still an issue.
Something else fun that happens when people cut the carbs is that they tend to still eat the same junk-food (chips, breads, etc.), but in smaller amounts. Less carbs does not change food quality. If you just decrease the unhealthy carbs but don’t add the healthier ones, you are still not feeding your body right! Let’s say for example you normally have a sandwich for lunch. You since cut back to ½ a sandwich; however, now you are hungrier. So, you end up doing some more lunchmeat or loading up on extra peanut butter. I’m not saying that it is okay to eat the chips, white breads, cakes, and cookies. What I am saying is that whole grains, beans, quinoa, etc are all great carbohydrates that can be incorporated into a healthy meal plan. The reality is that most people are not consuming enough whole grains (see research article below) and eating whole grains and beans are a great way to help decrease disease risk!
 ----> “Including pulses in the diet is a healthy way to meet dietary recommendations and is associated with reduced risk of several chronic diseases.”4
 ---->“Average intakes of whole grains are far below recommended levels across all age-sex groups, and average intakes of refined grains are well above recommended limits.”5
            
3. Low-carb to carb-binge
A couple things tend to happy with a low-carb diet. The first is that many tend to overload on the protein, which most people are getting enough if not more than enough of their recommended intake. Secondly, most people tend to crave the carbohydrates so much that they binge on them in about a week or two and end up stopping "yet another diet." Hey, I am not saying you won’t lose weight eating low-carb, what I am saying is that this is not typically a sustainable diet. 

4.  Most low-carb diets don’t get enough fiber.
On the same topic as point #4, less carbs usually means less fiber. As I said, most people sub in the protein for less carbs. You know what most people are NOT getting enough of in their diet? Fruits and vegetables! What do fruits and vegetables have in them besides vitamins and minerals…FIBER! One of the most cut-out-veggies is the beans! Did you know that a half-cup of chickpeas has about 5g of fiber and a half-cup of kidney beans has 8g of fiber? Fiber is beneficial because it can help to decrease cholesterol levels, improve GI function, and also decrease your risk for heart disease. See the research below for more reasons to get in the fiber!
 ----> "High fibre may be better than high protein for weight (fat) loss in obesity.”6
 ----> “A high-fibre bean-rich diet was as effective as a low carbohydrate diet for weight loss, although only the bean-rich diet lowered atherogenic lipids.”7 
----> “Increasing fiber intake lowers blood pressure and serum  cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals.”8

So, what should you do now? Start by tracking your food intake. Maybe, you are eating too many refined carbohydrates (cookies, white breads, etc). Maybe, you are also eating too much in one sitting (3 cups of pasta). Maybe, your meals are unbalance (heavy in carbs or protein). Start by checking out your food log and seeing where you can incorporate a better meal balance. 

Aim for meals to have lean proteins, fiber-filled carbohydrates (whole grains) or starches, and some non-starchy veggies. An example of a balanced meal could be: tofu (protein), broccoli (non-starchy veg), and a red potato (starchy carb). Another example could be fish, sautéed spinach, and brown rice. Another example could be quinoa (protein + starchy carb), mushrooms and tomatoes (both non-starchy). A snack could be an apple and peanut butter or veggies and hummus. The options are endless! 

Bottom line here, instead of eliminating a food group and possibly making yourself miserable aim for meal balance and portion control. If all else fails, find a Dietitian to help you with meal planning since we are the experts when it comes to nutrition :)

Additional Links

Resources
1. Chan H, Yiu K, Wong C, Li S, Tam S, Tse H. Increased dietary fruit intake was associated with lower burden of carotid atherosclerosis in Chinese patients with Type 2 diabetes mellitus. Diabetic Medicine [serial online]. January 2013;30(1):100-108. Available from: Academic Search Premier, Ipswich, MA. Accessed June 29, 2016.
2. Åsgård R, Rytter E, Basu S, Abramsson-Zetterberg L, Möller L, Vessby B. High intake of fruit and vegetables is related to low oxidative stress and inflammation in a group of patients with type 2 diabetes. Scandinavian Journal Of Food & Nutrition [serial online]. December 2007;51(4):149-158. Available from: Academic Search Premier, Ipswich, MA. Accessed June 29, 2016.
3. Satija A, Bhupathiraju S, Hu F, et al. Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies. Plos Medicine [serial online]. June 14, 2016;13(6):1-18. Available from: Academic Search Premier, Ipswich, MA. Accessed June 29, 2016.
4. Mudryj A, Yu N, Aukema H. Nutritional and health benefits of pulses. Applied Physiology, Nutrition & Metabolism [serial online]. November 2014;39(11):1197-1204. Available from: Academic Search Premier, Ipswich, MA. Accessed June 29, 2016.
5. Dietary Guidelines for Americans 2015
6. Adam C, Gratz S, Ross A, et al. Effects of Dietary Fibre (Pectin) and/or Increased Protein (Casein or Pea) on Satiety, Body Weight, Adiposity and Caecal Fermentation in High Fat Diet-Induced Obese Rats. Plos ONE [serial online]. May 25, 2016;11(5):1-16. Available from: Academic Search Premier, Ipswich, MA. Accessed June 29, 2016.
7. Tonstad S, Malik N, Haddad E. A high-fibre bean-rich diet versus a low-carbohydrate diet for obesity. Journal Of Human Nutrition & Dietetics [serial online]. April 2, 2014;:109-116. Available from: Academic Search Premier, Ipswich, MA. Accessed June 29, 2016.

Sunday, June 5, 2016

Facts About Erythritol

If you have been choosing more reduced calorie beverages or plant-based sweeteners, you may have noticed the products being made with sugar alcohols. Sugar alcohols are a type of reduced-calorie sweetener and no, they do not contain any alcohol! You can find sugar alcohols in baked goods, candy, ice cream, beverages, and even some plant-based sweeteners. Often these products are promoted as being lower calorie, having "no added sugar," or being suitable for Diabetics since they have a lower carbohydrate count. According to the American Diabetes Association, "Sugar alcohols provide fewer calories than sugar and have less of an effect on blood glucose (blood sugar) than other carbohydrates."1 Some commonly used sugar alcohols include erythritol, lactitol, maltitol, mannitol, sorbitol, and xylitol. While sugar alcohols can have a laxative effect in some people, not all sugar alcohols are created equal. 

Erythritol is a sugar alcohol that is about two-thirds the sweetness of regular sugar; however, it only contains one-twentieth of the calories. It is found naturally in pears, melons, and grapes; however, mostly all of the erythritol used in the industry is produced by fermenting glucose with various yeasts.2 Erythritol is often blended with stevia leaf extract, monk fruit extract, or other sweeteners in beverages to help reduce calories and also mask any aftertaste.

One of the benefits of using erythritol is that it does not cause tooth decay because it is not digested by bacteria. Also, according to the Center for Science in the Public Interest, "Erythritol's relative safety is due to its being mainly absorbed in the bloodstream and excreted unchanged in the urine. Other sugar alcohols stir-up trouble in the colon where they attract water (leading to diarrhea) or are digested by bacteria (causing gas)."2 In a study published by the National Institute for Health, it was found that erythritol was well-tolerated in feeding studies (mixed into the diet at concentrations as high as 20%) without any toxicological effects even after a high-dose exposure. 3 Similar to the statement by the Center for Science in the Public Interest, when erythritol was given to humans it was rapidly absorbed and excreted without changing metabolically, which again means little to no diarrhea or gas (like your other sugar alcohols).

While the sensitivities of people may vary, most adults can safely consume up to about 50g of erythritol per day.2 Just for reference here, 1 packet of Truvia® contains 3g of erythritol, a 12-ounce can of Zevia® Zero Calorie Soda contains 4g, a 18-ounce Bai® Antioxidant Infusion beverage contains 8g, and an 11.5-ounce can of Bai Bubbles® contains 12g.

Stevia plant

References
1. www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/sugar-alchols.html
2. www.cspinet.org/reports/chemcuisine.htm
3. http://www.ncbi.nlm.nih.gov/pubmed/9862657
4. https://www.truvia.com/products/truvia-packets
5. http://www.zevia.com/content/what-erythritol