"I skip the rice, no bread for me, no sugar in my coffee, no fruits, no vegetables that are naturally sweet" - This personifies a typical low carbohydrate diet that most weight controllers follow. Nowadays, unhealthy fad diets have labeled carbohydrates as the bane of weight loss efforts.

Is that true? Are carbohydrates our number one health enemy?
Absolutely, Not!
Over the years, this has been the mantra of  the  popular low and very low carbohydrate diets. They have made culprits out of carbohydrates and given them a bad rap. In fact, carbohydrates are one of the most misunderstood nutrients today!

There is some truth to the fact that carbohydrates are harmful. But, that's only half the truth! The other half is that carbohydrates are harmful only if chosen incorrectly. Carbohydrates are actually an indispensable part of any balanced diet.
 
The three macro-nutrients - carbohydrates, proteins and fats provide energy to the body. Carbohydrates are the main source of energy. They are found in two forms:  Simple (eg. glucose, fructose,lactose) and complex  (e.g. starch, cellulose). Both forms provide 4 calories per gram. They both give glucose as the end product of digestion. Yet the body reacts differently to both forms.

Simple carbohydrates get digested in a short time, but  glucose is released into the blood stream quickly. Thus, the post prandial blood glucose levels tend to suddenly spike. These carbohydrates have a high glycemic index. Insulin  which is required to remove this  glucose from the blood is unable to deal with this sudden surge, especially in diabetics, so glucose remains in the blood, causing hyperglycemia.  These simple carbohydrates also lead to food cravings , higher food consumption and ultimately weight gain. Simple carbohydrates are  thus considered to be "bad carbohydrates".

On the other hand.

When complex carbohydrates are eaten, the body takes longer to digest them, so glucose is released slowly and steadily into the blood stream. Insulin is able to deal with this slow rate of release much more effectively. These are carbohydrates with a low glycemic index and lead to better glycemic control. They have good satiety value and make the person feel fuller for a longer period of time and lead to less overeating. They make an excellent choice for weight watchers. They  are considered to be "good carbohydrates".

50-60% of daily calories for diabetics should come from carbohydrates. But the bulk of this should come from the complex variety of carbohydrates or the good ones. Simple carbohydrates are found in table sugar, candy, refined cereals, desserts, sodas, honey, molasses etc.and these should be avoided. They are usually devoid of other nutrients and fiber unlike the complex ones found in whole grain cereals, legumes, vegetables and nuts, which are also rich in nutrients and fiber. Did you know that fiber also plays an important role in lowering cholesterol, cancer risk and blood pressure.

Some foods like fruit and milk also contain simple carbohydrates but they should not be avoided because they are rich in vital nutrients and are essential for good health.

 For good glycemic control diabetics must keep in mind the following:  
1.    Regular meal timings, correct time spacing of meals and matching of mealtime schedules to insulin are very important.
2.    Carbohydrate counting  is an effective way of keeping track of  total carbohydrate intake.
3.    Studies have shown that consistency in the source and type of carbohydrates from day-to-day is associated with better glycemic control especially for  patients with type1 diabetes as compared with those who have varied daily  intakes.
4.    Regular exercise improves insulin sensitivity  and leads to better glycemic control.
Choosing the right kind and amount of carbohydrates coupled with moderate level physical activity can work wonders in weight reduction diets and in achieving good glycemic control. It makes the person feel healthier and energetic in the short run and reduces the risk of diseases in the long run.
So seek out your good carbohydrates during breakfast (oats), snacks (small servings of nuts and fruit or low fat milk), lunch and dinner (small portions of whole grains with vegetables and low fat yogurt with fruit)                                 

By. Poonam Vaswani,                                                                         
Dietitian,                                                      
NutritionVista.com


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