# Confused! Low carb or eat carbs at every meal



## sharon11 (Sep 3, 2012)

Ok I'm confused. I've always been told to eat carbs at every meal. Can someone tell me why then are there loads of posts titled low carb meals/breakfasts etc. the other day I had a mackerel salad for lunch without any carbs and my sugars were the best they'd ever been. Please help x


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## everydayupsanddowns (Sep 3, 2012)

You are not the first to be confused by the various forms of (lots of) carbs at every meal advice. 

There are many thoughts as to be origins, some more full of conspiracy than others. Essentially though all carbs turn to glucose in the blood - and many that are marketed as 'healthy' will do so at least as rapidly as table sugar. 

It is difficult (though not impossible) to choose a diet almost entirely free of grains and starch, so many people end up with an 'eat to your meter' approach. Moderating/lowering carb intake for improved BGs (and often better chol and splits as a handy byproduct)

This might mean low or very low carb breakfast. And low-moderate lunch/eve meal. I've seen T2s suggest 100g or thereabouts a day as a decent starting point, though I know many who go lower and still eat a wide ranging interesting diet.


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## everydayupsanddowns (Sep 3, 2012)

You might find this from a healthcare professional conference interesting:


> After lunch a variety of workshops were available covering different aspects of diabetes self-management education, and the day ended with a lively debate on the motion: _"Starchy carbohydrates with every meal is good advice"_. This generated much discussion followed by a vote, which *rejected the motion*. Interestingly this recommendation was removed from the Diabetes UK website just before the conference, which reflects a growing recognition that such advice is less appropriate during the current obesity pandemic which influences so much of our work nowadays.



http://www.diabetes-education.net/index.php?link=conference


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## DeusXM (Sep 4, 2012)

As Mike says, it's about finding what works for you. Much of the advice relating to 'needing' carbs is about 40 years out of date and harks back to a time when insulins weren't very flexible and the main concern was avoiding hypos. Eat what works for you. Remember that there isn't an RDA for carbs (carbs are not essential for any metabolic process as glucose can be derived from protein and fat can supply the majority of the energy you need). 

So basically, eat what you find gives you good control, and don't listen to anyone telling you that you need to cut out carbs, or that you should never have a meal without starch.


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## everydayupsanddowns (Sep 4, 2012)

DeusXM said:


> So basically, eat what you find gives you *good control*, and don't listen to anyone telling you that you *need* to cut out carbs, or that you should *never* have a meal without starch.



Exactly right I'd say - though for many (most?) T2s who have had it drilled into them that 'carbs are a must at every meal' significantly reducing carb intake is often a revelation.

Sharon - If you've not come across it already check out 'Jennifer's Advice' or 'Test Review Adjust' by Alan S (see useful links thread) for a good structure of testing to help you evaluate how your body reacts to food in BG terms.


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## DeusXM (Sep 4, 2012)

> Exactly right I'd say - though for many (most?) T2s who have had it drilled into them that 'carbs are a must at every meal' significantly reducing carb intake is often a revelation.



Absolutely - I'm just trying to avoid being accused of being pro- or anti- any particular 'side'. 

I've had plenty of experience with militant Bernsteiners freaking out over anyone eating more that 6g of carbs for a meal, and those who who relentlessly rage that a load of potatoes are essential to avoid being seconds away from a fatal hypo.


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## heasandford (Sep 4, 2012)

The only problem with removing carbs is that the calories have to be replaced with something. 
If fat, then ensure they are mono or unsaturated, saturated fats are a risk for cardio-vascular problems. If protein, the metabolic process of producing energy puts some pressure on the kidneys. It is also not very environmentally sound to use protein just for energy - I know this is the last thing to worry about when considering personal health, but just reducing carbohydrates would still provide enough for energy. 
(OK, awaiting the backlash!!)


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## DeusXM (Sep 5, 2012)

> If fat, then ensure they are mono or unsaturated, saturated fats are a risk for cardio-vascular problems.



Why?

The supposed 'issue' with fats is when they are stored, NOT when they are metabolised. 

If you are metabolising the fats that you eat, they will be used up. So they won't be stored. Which means they can't clog your arteries.

Fat only clogs arteries when other things in your diet are being metabolised first, leading the fat to be stored. Your body's metabolic preferences go something like alcohol, sugar, complex carbs, proteins and fats. That's why people who eat chips get fat - not because chips are 'fatty', but because in chips, you'll metabolise the large quantity of carbs first in preference to the fat, which then just floats around and sticks to everything. Plus, don't forget that rises in blood sugar are converted directly to stored fat through insulin. Which then raises a worrying question that perhaps carbohydrates have a far bigger impact on CVD than most people realise, and potentially could have a far greater impact than fats.

Think about it. When someone is told to lose weight, essentially, they are told to metabolise their body fat. Your body fat is saturated fat and biochemically has no meaningful difference from any other saturated animal fat you may eat. If metabolising saturated fat actually caused cardiovascular disease, everyone who lost weight would have a heart attack. Instead, people who lose body fat enjoy BETTER health outcomes, despite the 'fact' that using fat for energy is bad. All the statements that dieticians make about dietary fat are all based on the assumption we are also eating 300g of carbohydrate a day. Remove that assumption, and suddenly you get into really interesting territory.


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## MaryPlain (Sep 6, 2012)

DeusXM said:


> Why?
> 
> The supposed 'issue' with fats is when they are stored, NOT when they are metabolised.
> 
> ...



This is the most helpful explanation I have seen about this issue, thank you. I'm currently trying to lose weight and have been reducing carbs but not extremely so: it varies between about 80 and 120g a day. Does this mean that I do need to worry about the type of fat I'm eating? I am vegetarian so a lot of my protein intake is from cheese. Low fat cheese is horrible!


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## DeusXM (Sep 7, 2012)

> Does this mean that I do need to worry about the type of fat I'm eating? I am vegetarian so a lot of my protein intake is from cheese. Low fat cheese is horrible!



The honest answer is, I don't know. Fat metabolism requires your body to be in ketosis - I'm not sure this is possible if you're eating 120g of carbs a day. Generally I would say that provided you are eating fewer overall calories to what you require and you are exercising, the fat may not be as significant an issue as it's made out. Certainly it's not as simplistic as 'sat fat is bad, no matter what'.

If you're looking for more protein sources, are you using things like tofu and mycoprotein (Quorn) at all?


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## everydayupsanddowns (Sep 7, 2012)

I'm not sure either. 

To my mind fat, like carb is 'energy dense' so you don't need much of it to increase the calorie intake of a meal. In the absence of readily available carbs the body seems to get better at metabolising proteins and fats into glucose (which I suppose is why many low carbers seem to see improvements in their total cholesterol and splits despite often eating far more saturated fat). I don;t know the level at which that would happen (possibly <100g a day which I've seen suggested in some places as a bit of a tipping point, though I suspect it would probably be different for everyone).


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## heasandford (Sep 7, 2012)

DeusXM said:


> provided you are eating fewer overall calories to what you require and you are exercising, the fat may not be as significant an issue as it's made out.



I believe that's the important message!

Humans have developed as omnivores, but with an emphasis on carbohydrates as we became settlers not hunter-gatherers We developed a more complex brain as a result of this. The reality is that we people with diabetes are 'genetic failures' so may have to follow different rules and that's up to us to find out what they are... (hope that's not too derogatory)


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## MaryPlain (Sep 7, 2012)

DeusXM said:


> The honest answer is, I don't know. Fat metabolism requires your body to be in ketosis - I'm not sure this is possible if you're eating 120g of carbs a day. Generally I would say that provided you are eating fewer overall calories to what you require and you are exercising, the fat may not be as significant an issue as it's made out. Certainly it's not as simplistic as 'sat fat is bad, no matter what'.
> 
> If you're looking for more protein sources, are you using things like tofu and mycoprotein (Quorn) at all?



Quorn is a staple, but I'm not that keen on tofu and my husband hates it. I eat edamames and soya milk on my cereal though. I just find that cheese is my favourite type of protein by a long way!

Thanks for your honesty anyway. You say that fat metabolism only happens in ketosis - in which case how do low calorie moderate carb diets work? I've been quite successful in losing weight, so presumably burning fat, without being in ketosis - but I suppose that's different from burning the fat I eat?


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## DeusXM (Sep 8, 2012)

> You say that fat metabolism only happens in ketosis - in which case how do low calorie moderate carb diets work?



Mike probably said it better, I wasn't too clear. If there's a negative calorie balance, you'll metabolise your body fat through ketosis, but the fewer carbs you eat, the more effective this process seems to become.



> Humans have developed as omnivores, but with an emphasis on carbohydrates as we became settlers not hunter-gatherers We developed a more complex brain as a result of this.



It's hard to get into 'what we evolved to eat' without getting into wild speculation, but I would say that this is incorrect. Our complex brains were what caused us to become settlers, rather than vice versa, and most conventional science suggests this is a result of our earlier ancestors (ie. members of the Homo genus before us, Homo sapiens) eating more protein. Carbs can't be used to grow organs. Larger starch intake came AFTER our brains had increased in size.

Where eating more starchy carbohydrates comes is with the estimated dawn of farming, around 12,000 years ago. This also happens to be roughly when 'civilisation' starts - a steady supply of calorie rich food meant people could therefore spend less time hunting and more time thinking. This doesn't equate that carbs are the best food choice for us or anyone else - they're just an energy rich food source that's easier to acquire and preserve.


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## HOBIE (Sep 8, 2012)

I dont know who told you to have carbs !    It depends what you are doing, Sitting down all day (NOT MUCH). Running a marathon (YOU NEED SOME). I quite often just eat fish. No carbs !


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## everydayupsanddowns (Sep 8, 2012)

I also wonder think we burn fat at low levels more often than we might think, and certainly without going intonation we might think of as full-on ketosis (though happy to be corrected if I have that wrong). I'm pretty sure a DSN once told me that it is not uncommon for some people to wake with very low level ketones because of the time between meals overnight.


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## Mark T (Sep 8, 2012)

If detecting ketones in urine indicates some form of ketosis - then you can fairly easily manage it on moderate levels of carbohydrate intake.  I had some urine test strips for glucose/ketones that where running out of date - so I decided to do some tests.

I found that I will test slightly positive (usually 2/5 or 3/5) for ketones if I use a test strip before I go too bed after I've had a couple of glasses of red wine - this is because the alcohol inhibits the production of glucose from your liver.

I can also go 3/5 or 4/5 If I decide to do a 30 minute quick walk (say 5 km/h+) before lunch instead of after lunch - these are essentially starvation ketones I believe.


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