Older Bolder Life

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Carbohydrates

Picking the Low Hanging Fruit: Dial Back the Carbs

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It’s been several days since I wrote about picking the low hanging fruit (the simpler, foundational principles) along one’s journey to restore (or improve) your overall health and wellness. Last week I offered up some simple principles related to protein and incorporating more movement into your daily routine.

Of note, my thoughts today are aimed at those who are following an approach to nutrition and food much more aligned with the Standard American Diet (the infamous SAD approach), not necessarily those thoughtful folks who have already begun to take a hard and discerning look at the healthy – and the unhealthy – aspects of their nutrition plan.

So How Many Grams of Carbohydrate Does “the Average American” Eat Per Day?

Good question, and when you get right down to it, defining the “average carb intake” of any group or population is devilishly difficult to do with genuine scientific accuracy, though there are plenty of ways to ballpark the numbers fairly closely.

For example, let’s look at carbohydrate intake suggestions from the venerable Mayo Clinic, written in February of 2017 –

The Dietary Guidelines for Americans recommends that carbohydrates make up 45 to 65 percent of your total daily calories.

So, if you get 2,000 calories a day, between 900 and 1,300 calories should be from carbohydrates. That translates to between 225 and 325 grams of carbohydrates a day.

Impressive, particularly in light of two things: first, there are impressive numbers of individuals who consume a far more than 60 percent of their daily calories from carbohydrates. And secondly, there’s been an explosion of very credible information over the past couple of decades, more so in the last decade, frankly destroying the concept that carbohydrates are our bodies preferred, principle fuel.

That said, where does one start when looking to manage carbohydrate intelligently?

Starting Your Approach to Dialing Back Your Carbohydrate Intake

Coming from the perspective of eating the Standard American Diet (SAD), once you’ve settled on a rational approach to protein intake, for most of us, it’s time to dial back the carbs.

How far? It really doesn’t have to be that complicated, and for all the chatter about carbohydrate intake floating about these days, I still find Mark Sisson’s diagram below – his carbohydrate curve – to be one of the must useful illustrations of the concept.

If you’re eating 300 grams of carbohydrate a day, dropping down to 150 or 100 grams/day isn’t necessarily going to happen overnight. You can drop quickly, we did years ago, though we’re sorta “rip the bandage off in one quick pull” kinda people, and our process wasn’t without some cravings and missteps along the way.

Part of the mechanism of dialing back your carbohydrate intake is based upon improving the quality of the carbohydrates you consume – eating fresh, whole foods and not highly refined, overly process, carb-dense preparations is a huge part of the game here.

For a little more detail, take a look at Carbs: The Good, The Bad, and The Ugly (Part 1 is the Bad and Ugly, Part 2 The Good).

And Finally, Remember the Carb Game is Won By Finding Your Carb Tolerance Point

A critical reminder from a prior post – your optimal carb zone and macronutrient partitioning needs depend on a host of factors THAT ARE UNIQUE TO YOU; potentially including (a short list, just for example):

Your current objective(s): be it weight loss, athletic performance, cognitive improvement, general well being, longevity, etc.
Your current body composition: Are you overweight, underweight, lacking appropriate muscle mass?
Your overall metabolic health: Are you in full-blown metabolic syndrome with insulin resistance, on the edge, or “fairly healthy”?
Your overall level of activity: Are you a cubical-bound couch potato whose idea of a workout is the walk to and from the car in the parking lot, an occasional, casual walker, perhaps working a physically demanding job, or a gym rat?
Your overall general health: Do you have conditions that impact your body’s functions in a material way, such as joint problems (degenerative arthritis), heart disease or hypertension, poor sleep, or stress you can’t manage?
Your age: For example, protein requirements increase in the elderly, and the elderly’s protein requirements may be more impacted by higher activity levels.
Your current progress in your recovery journey: Your best macronutrient partitioning will change over time, pending where you are in your health and wellness journey, and as you purposefully get leaner, more fit, and thoughtful about how you fuel your mind and body.

There will be some trial and error, and some N=1 experimenting to find your sweet spot. Get started today, and we’re here to help guide you through the process if it seems a bit overwhelming. Git ‘er done.

Carbs: The Good, The Bad, and The Ugly (Part 2 – The Good)

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From yesterday’s post about The Bad and Ugly Carbs –

Of all the questions about a healthier lifestyle I typically field from curious potential clients, friends, and family, by far and away the most common one has to do with carbohydrate consumption, and most specifically, “what are the good carbs I can still eat?”

Of note, this isn’t a discussion of the science underpinning the (common-sense) rationale for choosing a lower carb, moderate protein, higher fat lifestyle – it really is a lifestyle, not a “diet”; this discussion is meant to lay out a practical, fairly concise (maybe not) roadmap for those who’ve made the decision to give this concept a spin.

Yesterday we talked about unhealthy carbs, the bad and ugly carbs if we’re going to hold to that metaphor, that need to be swept out of your life, and for those of you pondering jumping onto this healthy bandwagon, probably swept out all at once.

A Word About Carb-Phobia

As has happened to many of us in the Primal/Paleo/Ancestral health worlds, at some point you might be accused of being “Carb-phobic” by someone touting a high-carb, low-fat approach to food, or by someone mired in the muck of a SAD diet.

Frankly, nothing could be further from the truth.

This isn’t a carb-phobic approach, it’s actually the polar opposite. This approach leverages all the best nutrient-dense, fiber-packed, texture and flavor-rich carbs available with little if any of the excessive, insulin-spiking, glucose floods that highly-processed carbs bring to the table.

This isn’t a carb-phobic approach, it’s a smart carb/intuitive carb approach.

So What “Good Carbs” Are We Talking About…

Let’s start with the easy one, the carbs I’d typically argue that you eat with abandon until sated, and the first on the list won’t surprise you – the green leafy vegetables:

  • Lettuce, all types
  • Chard
  • Greens – beet, collard, dandelion, mustard, turnip
  • Broccoli Rabe
  • Kale
  • Spinach
  • Purslane
  • Watercress
  • Sea vegetables – kombu, nori

Now throw in colorful and cruciferous vegetable all-stars:

  • Artichoke
  • Asparagus
  • Avocados (actually a fruit…)
  • Beets in moderation
  • Bell Peppers
  • Bok Choy
  • Broccoli
  • Brussel Sprouts
  • Cabbage
  • Carrots in moderation
  • Cauliflower
  • Celery
  • Cucumbers
  • Eggplant
  • Endive
  • Fennel
  • Garlic
  • Kohlrabi
  • Leeks
  • Mushrooms (most varieties)
  • Olives
  • Onions
  • Parsnips in moderation
  • Peppers
  • Purslane
  • Radish
  • Rutabaga in moderation
  • Tomatoes

The best fruits are those lower in fructose (read Dr. Gundry’s pitch on fructose if you haven’t yet); the top choices include:

  • Blackberries
  • Blueberries
  • Boysenberries
  • Cranberries
  • Gooseberries
  • Raspberries
  • Strawberries

I’d like to cover other fruits in more detail in another post, given the complexities of fructose processing and the nuances of using fruit to best accomplish your goals, whether those goals be simply optimizing your nutrition, further weight loss, physical performance enhancement, or accommodating a unique metabolic or functional quirk of your own.

If you haven’t yet, it’s time to jump on the Good Carb train and get moving toward your health and wellness goals.

Carbs: The Good, The Bad, and The Ugly (Part 1 – The Bad and Ugly)

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Of all the questions about a healthier lifestyle I typically field from curious potential clients, friends, and family, by far and away the most common one has to do with carbohydrate consumption, and most specifically, “… so what are the good carbs I can still eat?”

Of note, this ISN’T a discussion of the science underpinning the (common-sense) rationale for choosing a lower carb, moderate protein, higher fat lifestyle – it really is a lifestyle by the way, not a “diet”; this discussion is meant to lay out a practical, fairly concise (maybe not) roadmap for those who’ve made the decision to give this concept a spin.

That said, let’s first tackle The Bad and The Ugly carbs that need to be left in the proverbial dust as you turn the page on the SAD (standard American diet) days of the past and take a very intentional first step toward a healthier approach to food.

An Over-Simplified Overview of the Carbohydrate Problem

I often explain to friends and clients that problematic foods in the SAD way of eating can be thought of as the legs of a three-legged stool: those problematic legs are grains, sugars in their various forms, and heavily processed, chemically-altered, often hydrogenated fats and polyunsaturated vegetable oils.

Oils we’ll tackle on another day, but today let’s talk about grains and sugars.

Of note, it simply isn’t possible to explain a topic this complex in a matter of a few paragraphs; there are entire books (take Wheat Belly by William Davis, MD as a prime example) that have detailed grains’ egregious impacts on human physiology in detail. We’ll delve into more of the nitty gritty at a later time, but here we’ll run through the highlights (or lowlights) of the grain and sugar problem.

Granted, for the last 10,000 years or so of human history, grains have been the cornerstone of human consumption. The challenge for our human physiology with regard to grain is quite simple however, that being that grains delivered insanely excessive levels of carbs to our systems, along with a bevy of anti-nutrients (i.e. gluten, among a host of other lectins, and phytates in excess).

Ingested and absorbed carbs that aren’t immediately burned are converted into triglycerides in the liver and stored in fat cells. Chronic pattern of high-carb consumption triggers excess insulin production, which then triggers hormonal responses (for example cortisol and adrenaline responses) that trigger, among other things, excessive systemic inflammation.

Often overlooked is the simple concept, detailed by many over the years, that as humans we do not have a documented, essential need for any processed carbohydrate to run our bodies at peak efficiency. Don’t let anyone tell you otherwise.

So What Grain and High-Carb Products Get the Boot?

All bread and flour products. The list is long and distinguished – all breads, donuts, scones, crackers, tortillas and tortilla products, pizza, sandwiches, etc.

Sweets and desserts – cookies, brownies, pies, cupcakes, cake, etc. (all baked treats), candy and all confections, frozen desserts (damn), and all sweeteners.

Grains you cook with – barley, bulgar, couscous, millet, rye, amaranth, grits and polenta.

Pastas – yep, even the special versions enhanced with other legume or vegetables.

All rice, though note that wild rice can be an exception as it’s actually a grass, not a grain, though still has a fairly high high net carb content.

All chips and puffed/puffy snacks – think things like Cheetos, goldfish, popcorn, and the infamous rice cake.

Baking ingredients – all flours, corn meal, corn starch, typical baking powders (milk, bread gluten, maltodextrin), sweeteners like corn syrup, dextrose, fructose, lactose, malitol, and xylitol; baking mixes are out the window too. Chocolate (and other sweet baking chips) are to be avoided, though choc chips with >70% cocoa or unsweetened 100% cocoa powder can be used judiciously for a treat!)

Oatmeal and other grain-based cereals.

Syrups, especially HFCS or agave-based, are to be avoided.

Beware these beverages: designer coffee drinks, fruit juice and fruit-flavored drinks, energy drinks, milk and non-dairy milks (almond, rice, soy, etc), sports drinks, sodas, sweet tea, sweet cocktails.

Condiments to ditch: standard ketchup, jams, jellies, and preserves, honey mustard, mayonnaise (unless you’re making your own with acceptable oils), salad dressings with PUFA oils, low-fat salad dressings. Watch condiments carefully, many contain shocking amounts of HFCS.

Fast foods, prepared-ahead/highly-processed foods and food products (read those labels).

Legumes’ role in a Primal-type food plan might be debated by some, though particularly for those not yet at their ideal body weight with weight to lose, legumes bring a high-carb burden for the nutrients they typically bring to the table, and should be avoided or certainly minimized. Legumes to avoid include alfalfa, beans, peanuts (and PNB), peas, lentils, soybeans (that means tofu too).

Starchy vegetables, to consume in moderation or avoid, pending your goals and current status, include potatoes (white-fleshed potatoes certainly, sweet potatoes and yams in moderation), cassava, taro, squash (including pumpkin), and some would put beets, carrots, Jerusalem artichokes, parsnips, and rutabaga on this list as well.

Tomorrow let’s talk about Good Carbohydrates…

Letting Simple Physiology Inform Your Carb Choices: An Example

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I shared a few weeks back a discussion I had with a skeptical physician friend after he’d approached me for input on how he might best approach turning his health around; read my recount of our interaction (part 1 and part 2) here.

We’ve chatted back and forth over the past couple of months, working through his traditional medical training induced skepticism for a lower carb / moderate protein / higher fat food plan and I thought it might be worth sharing what finally convinced him to jump into a trial with both feet.

What finally convinced him was encouraging him to let simple human physiology inform his food choices, particularly when it came to carbohydrate intake.

For illustration purposes, I constructed a hypothetical man, weighing 190 pounds, and used one of the many tools available to estimate his blood volume, which turned out to be 6464 ml.

I then asked him what he’d like to consider as a “normal” blood glucose level (granted, there are a host of influences on what might be a normal level); he suggested we use 100 mg/dl (to make the math easy, and that’s 5.5 mmol/l for those thinking along those lines).

In our hypothetical man, a blood glucose level of 100 mg/dl, given his estimated blood volume per above, means that only 6460 mg of glucose is in circulation at any given moment. That’s all of 0.228 ounces, which, when visualized in terms of table sugar (yes, that’s sucrose, but we’re painting a visual picture here), ends up just a hair over 1 and 1/2 teaspoons.

In our hypothetical man, a blood glucose level of 130 mg/dl – deemed to be the acceptable upper limit of normal, given his estimated blood volume per above, means that only 8398 mg of glucose is in circulation at any given moment. That’s all of 0.296 ounces, which, when visualized in terms of table sugar (yes, that’s sucrose, but we’re painting a visual picture here), ends up being just about 2 teaspoons.

I reminded him of how aggressively the body responds to carbohydrate consumption, which produces a flood of glucose into the bloodstream inducing the cascade of insulin responses (here’s a quick reminder, it’s oversimplified, but a review).

Visualizing what relatively small amounts of blood glucose are actually in circulation at any given time, thinking through the very elegantly designed hormonal controls in place to keep blood sugar very tightly regulated, and well understanding the ravages of blood glucose elevated out of normal ranges (i.e. T1DM), finally ‘flipped the switch’ in my friend’s thought process, at least in the context of the standard American diet and the (relatively speaking) huge load of carbohydrates it provides.

Sometimes simple examples win the day.

The Carb Conundrum That Really Isn’t (Part 2)

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Yesterday I shared an interesting email from a physician friend lamenting the widely varying recommendations about carbohydrate consumption discussed in the medical and lay press these days.

We agreed to spend thirty minutes on the phone together to allow me to present a simple collection of five suggestions to him; the discussion focused on the following. (I’ll be delving into the established science in each of these areas in later posts; to do so here and now would simply be too much to cover…)

You Say Low Carb, I Say Thoughtful, Careful, Smart Carb

The longer I personally live what most would call a ‘Primal Lifestyle’, the more I feel we’re probably mischaracterizing the optimal approach to carbohydrates in a healthy diet.

We’re not carb-phobic, or carb avoiding. Quite the contrary.

What we’re really talking about here is a Thoughtful, Careful, Very Intentional Carbohydrate approach (some even frame it as Smart Carbs), selecting nutrient-dense, fresh, insoluble fiber-rich, whole sources of carbohydrate, and avoiding (like the plague) highly refined and processed carbohydrate sources, like sugars, just about all grains, legumes, and overly sweet fruits.

One of my mentors early on challenged me to eat 30 to 50 grams of healthy carb vegetables a day (as part of a rational eating plan) and then argue that I didn’t find my hunger sated and energy needs met handily; I issued the same challenge to my friend…

Clearly for those who have existed and struggled as carb-fueled, binge and crash several times a day machines, there’s a transition journey, though for most it’s a molehill and not a mountain to cross.

Is Restoring Insulin Homeostasis the Key? (Yep, It Is.)

I reminded my friend of the critical and varied roles that insulin plays in the human body, in addition to one of its principle tasks, that being the storage of excess ingested nutrients, most commonly as stored fat. There’s no question that high carb diets chronically elevate insulin levels, keeping fat locked in storage, and over time, lead to development of insulin resistance, which among a myriad list of undesirable effects, makes it much, much harder to drop excess body fat.

Chatting about this, we found we both share a particular interest in insulin’s effects on brain metabolism and aging (here’s an interesting read on some probable mechanisms in the brain).

Thoughtful, Careful, Smart Carb: Embrace the Good, Out with the Bad

A few weeks back I wrote –

There are several foods, ironically centerpieces of the typical American diet, that contribute more to the damaged and deranged health of the population than anything else – sugar, grains, and the highly-oxidized, polyunsaturated, industrially-processed vegetable and seed oils being the worst of all.

Eating a SAD diet, these three categories often make up the preponderance of calories consumed, despite the hard science record that carbs are the principle driver in determining body composition and that excess glucose (yep, we’re looking right at you grains and sugars) is the root culprit fostering the obesity epidemic and the flood of disorders (i.e. T2DM, heart disease) that walk hand in hand with it.

This isn’t a carb-phobic approach – it’s sweeping the crap carbs out of your diet, and replacing them fully with nutrient-dense, fiber-rich, healthy carbs at levels that make sense physiologically.

I reminded my friend that dialing in optimal, quality carbohydrate intake goes hand in hand with consuming moderate amounts of quality proteins, which contributes impressively to satiety, along with consumption of healthy, appropriate fats.

Thoughtful, Careful, Smart Carb Brings Out the Fat Burning Beast

We talked briefly about the growing body of data suggesting that fats (and some of their metabolic derivatives, i.e. ketone bodies) very well may be the body’s preferred, most efficiently utilized fuel for anaerobic activities (the stuff we humans do for the vast majority of our days).

This is an enormous subject, and far too vast to cover in a few paragraphs (or a thirty minute conversation on the phone). Having just read it myself, I suggested my compadre grab a copy of Nora Gedgaudas’ most recent book Primal Fat Burner for a detailed, recent review of the science behind this growing and most interesting line of thinking.

Training your body to become fat adapted opens doors of (metabolic) flexibility that are truly game changing.

Thoughtful, Careful, Smart Carb Works for the Long Haul

Finally, my friend and I agreed that we’d both journeyed down various diet paths only to find these altered eating routines unsustainable over time.

Eating a thoughtful, careful, very intentional carbohydrate approach, coupled with high-quality, moderate protein consumption, and liberal enjoyment of tasty, healthy fats simply tastes good, one of, if not the most critical feature for longterm eating plan compliance.

Not only that, this type of eating plan is based on simple, easy to understand, almost common-sense principles that allow anyone to intuitively navigate the vast sea of food choices we face every day.

That said, I reminded him of a key point mentioned in yesterday’s post – the key imperative is paying careful, thoughtful attention to what your own body is telling you, and adjusting your approach to fit your own unique, (very likely) evolving physiology.

As noted above, we’ll be delving into each of these areas in more detail here on the blog over the next few months.

The Carb Conundrum That Really Isn’t (Part 1)

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Here’s part of an interesting email from a friend who has recently decided it’s (past) time to reshape his approach to food, starting moving again, and drop the 80 or so excess pounds he’s been carting around for the past decade.

As a way of background, he’s a physician (orthopaedic surgeon), busy family guy, still helps when he can with his parent’s ranch two hours away, is an avid hunter, and loves to cook and eat.

…I appreciate your time on the phone last week, and I’ve read through some of the sites you suggested, though clearly there are conflicting positions as to the roll carbohydrates play in the typical American’s diet, particularly those of us who are above our ideal body weight and in our 40’s or older.

I get that the traditional medical/nutritional establishment, as a larger collective, still touts various carbohydrates as the foundation of the food pyramid (even though they’ve more or less moved on from that construct), but even a cursory search of food plans to lower carbs yields what appears to be highly anecdotal recommendations that are all over the map.

Your simple explanation of a lower carb, moderate protein, higher fat approach makes sense on one hand, though what the hell is one to make of the no-carb carnivore stuff being waved around today? Or the high carb recommendations still flooding the sports medicine literature, particularly at the elite level and in the endurance disciplines. Or the high carb, high protein regimens that come out of the power lifting / body building worlds? Not to mention those choosing the vegetarian or vegan roads, of course neither of which are so carb-phobic.

For a guy still in practice today, this all presents something of a conundrum – actually two to deal with. One, recommending that patients lose weight as I sit on the stool next to them with my panniculus hanging over my belt rings a bit hollow. And two, dispensing specific nutritional advice to patients puts me on the hook in a way, and I damn sure want to engage personally with an approach that’s physiologically/scientifically sound.

You know where I’m coming from, and with your health success personally and study over the past few years, would you mind steering me to some solid, evidence-based data to incorporate here?

My wife and I have tried and failed with a number of different approaches, like The Zone, South Beach, Weight Watchers, and even some crazy thing she bought for over a grand that had us drinking meal replacement shakes twice a day that tasted like dirty socks soaked in dishwater with a sprinkle of Nestle’s Quick stirred in. We need something that is geared for the long haul that still lets us enjoy good food. We’ve both had enough of running out of energy two hours after eating and reaching for what must be the wrong snacks to reach the next meal…

Let’s Start With Some Simple Points about Food (and Life) to Agree On

Those of you who have chosen to amble down a food plan path different than that of the Standard American Diet (SAD) have heard some variation of the comments / questions levied by my friend above.

You also know that what initially might appear to be confusing for some – for example the differing carb intake recommendations my friend pointed out above – often comes into much sharper focus as one digs a bit deeper and separates the science from the noise AND takes an honest appraisal of one’s own health, unique physiology, and approach to food.

That said, I quickly responded to my friend and commended him for several things.

One, simply choosing to get started, drawing that line in the metaphorical sand, and deciding to make a change is a critical step.

Two, there’s no question that excess body fat isn’t your friend. As a busy orthopaedic surgeon making his living (for the most part) replacing hips and knees that have worn out, he understands this better than most. The obesity epidemic impacts the morbidity of his arthroplasty patients, their implant longevity, and eventual return to function (link), among other things.

The list could go on and on, but just for example’s sake, excess belly fat increases your risk of an early death, abdominal obesity increases cancer, cardiovascular, and all cause mortality, and can severely impact quality of life (including sexual function).

Three, the current SAD approach to nutrition clearly isn’t a workable longterm plan for health and wellness. Looking for proof? Explosion in adult obesity over the last 40 years? Check. Explosion in childhood obesity over the last 40 years? Check. Skyrocketing rates of T2DM, hypertension, auto-immune diseases over the last 40 years? Check. (Frankly, go to an area shopping center and people watch for 20 minutes…).

And four, I agreed with him that there is a tremendous amount of noise out there about carbohydrates and their role in human nutrition. That duly noted, there are good scientists, physicians, and health advocates telling the truth about carbohydrates around, and some diligent personal research and careful thought is called for here, as is the imperative of paying attention to what your own body is telling you (as evidenced by the simple fact that my friend’s current approach to food clearly wasn’t working by what he’d described).

More tomorrow on clarifying my buddy’s carb conundrum.