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Inner Workings has broken down the benefits and myths around both proteins and fats. Now we’re putting the spotlight on one of the most discussed, and often condemned, of all of the macronutrients: Carbohydrates. Do carbs deserve their bad reputation? Well, let’s go find out! In wellness, Mary Virginia But Before We Dive In… There’s a whisper in my ear, “Psst…wait - what’s a macronutrient?” Macro = large. A macronutrient is a major molecule in food that we need routinely in larger quantities in order to build our bodies and create energy. In contrast, a micronutrient is also an element in food that our bodies require, but only in very small amounts. Vitamins and minerals are micronutrients. There are three official macronutrients: protein, fat, and carbohydrate. While I’m boiling down carbs in this newsletter, these three really work in synchronicity in the body. As I often say, our bodies are intricate and complex. Ok, So What is a Carbohydrate? People can pretty easily identify a protein or a fat. But lots of people seem to be confused about carbohydrates. How many times have I heard, “But I had some chicken!” Carbs are made up of chains of sugar, and now you know the source of their supposedly bad reputation. When you understand them, though, you’ll see that they totally earn their macronutrient street cred. There are three foundational single sugar molecules (aka monosaccharides) that define a carbohydrate-rich food: glucose, fructose, and galactose. These combine to create disaccharides (which occurs when two sugar molecules bond together), which form many of the sugars we recognize:
Fuel Your Body Here’s what makes carbohydrates an important tool in our food toolbox. Our mitochondria - the powerhouses of the cell! - are designed by nature to use glucose as their #1 fuel source. In fact, this is so true that our bodies will actually transform other sugars and even fats and proteins into glucose so the mitochondria have a steady supply to power them. When we eat foods with carbs, we first use the glucose that enters our bloodstream to make energy. That’s why we feel so much better after we eat! Then, once our energy needs are met, our body stores some leftover glucose molecules in the liver and muscles as a back up. (Stored glucose is used later in three major ways: overnight to fuel our brain; to fuel our muscles when we’ve used up the ready glucose in our blood; and to fuel our whole bodies between meals when we’ve used up the glucose from our prior meal. That’s about when you’ll start to feel hungry.) If there is any left after that, then glucose is turned into fatty acids and stored in adipose tissue (body fat). This right here is why many people think carbohydrates = weight gain. It’s so important to understand the prior steps in the process and then work from there to meet your individual needs for this necessary macronutrient. Finally, and critically, our brains use about 20% of our daily energy, and brains really, really prefer glucose as their primary fuel. Most people’s bodies function best when 45%-65% of their daily caloric intake is sourced from carbohydrate-rich foods. That’s about 225 to 325 grams of carbohydrate daily. The higher end of that is likely best for people who burn a lot of energy daily, such as professional athletes or those who work in very physically or mentally demanding jobs. Obviously what makes one person feel best may not be right for someone else, so like other macronutrients, the right amount for you will be personal. The amount also could change in response to specific health conditions and/or therapeutic food plans (e.g. for brain and mental health). Simple vs. Complex Carbs Simple carbs are made from sugars that are already broken down into their most basic components - that is, simple carbs are short sugar chains, like sucrose, lactose, and maltose. Because they are already so small, they are very easily and rapidly absorbed through the small intestine into the bloodstream. Simple, right? Examples of foods that contain simple carbs: table sugar; sodas; juices; refined flours; baked goods (cookies, cakes, pies, crackers, bagels, pancakes, etc.); pasta; white rice; fruit filling in yogurt; potato chips; desserts, candy, and sweets; honey; agave; maple syrup; etc. Key to understanding simple carbs is that they are so easily absorbed into the bloodstream. This can be useful when our energy is really flagging and we absolutely need something to get us from here to there. High performing athletes, like marathon runners, need the ready energy of simple carbs before, during, and after their races to keep up their strength and stamina. Nevertheless, for the average Joe and Josephine, our bodies are not well designed to handle repeated swift spikes in blood sugar that arrive with consuming simple carbs often (occasionally having them won’t cause issues). Blood vessels like glucose best when it’s just passing through. Complex carbs, on the other hand, are found in foods in their most whole form (which are also more nutrient dense). The chains of sugars in complex carbs are long and - you got it - complex. They are also full of fiber, a type of complex carb that is consumed by our gut bacteria, sweeps out debris in our digestive tract, or is used to create bulk and softness in our stool. Between the complexity of the sugar chains and the fiber, these foods digest more slowly. This means that the sugars are released only bit by bit into the bloodstream - time release energy, if you will. Examples of foods with complex carbs include: whole grains (oats, brown rice, wheat, millet, amaranth, corn, etc.); starchy and non-starchy vegetables; whole fruit; beans and legumes; nuts and seeds (including quinoa, though their carbs are mostly as fiber). Try this experiment: take a bite of raw carrot and chew it really thoroughly. Maybe even close your eyes so you can focus on flavor. Can you taste the carrot getting sweeter and sweeter? That’s the sugars being broken down into their more simple forms. Where will you not find carbs? Meats, poultry, fish, or shellfish or any cooking or food prep oil. Good Carbs vs Bad Carbs I’m going to share something you may struggle to believe. There’s no such thing as a “good” or “bad” carb. I see you shaking your head in disbelief. This is a new perspective for a lot of folks who have experienced a diet-culture mindset. Remember, food has no moral value. It can’t be good or bad: it only exists as a practical tool for physiological and biochemical building blocks, fuel, and pleasure. It’s up to you to decide how and when you use that tool. For example, there’s not a thing wrong with choosing foods with simple carbs simply because you enjoy them. We bond and celebrate over many of these delightful sweets. What is a birthday without cake? My personal favorite ways to round out a meal are with a square or two of chocolate or a Mexican wedding cookie! Sugar is a natural taste preference for humans. Carb-rich foods from hunter-gatherer days to now have assured our bodies have the energy we need to live our lives. I follow an Instagram account called jennthedietitian. She captures neutrality around food so well!! I hope you will absorb my version of her message: “Some foods that taste good give us more vitamins and minerals. Others give us more joy and pleasure. Both are good for us.” Low Carb Diets Remember the primary role of carbohydrates? Energy production. When we persistently eat poorly designed low carb food plans, odds are that we will begin to drag. Those who eat low and very low carb food plans often end up on my office doorstep with fatigue, lethargy, brain fog, poor focus and attention, anxiety, depression, disrupted sleep, stubborn fat accumulation, and more. If we don’t consume enough carbs or fat (see my newsletter on fats), or if overall the body is not getting enough food, then it begins to break down protein, i.e. your muscles, to make the missing glucose, which in turn makes you weaker. And also, remember how much your brain loves glucose (have you seen the Ryan Gosling meme on this?) Many commercial weight loss plans are guilty of recommending long bouts of inadequate food intake overall to promote weight loss. Many people on these diets begin to lose muscle and strength along with shrinking fat. In case you’re new here, I am not a fan. High Carb Diets The flip side of the coin is when we have too much glucose in the blood repeatedly, often, and for too long. Blood glucose dysregulation ultimately triggers illnesses such as insulin resistance, diabetes, imbalanced cholesterol, cardiovascular diseases, mood disorders (anxiety, depression), and sleep disturbances, and can even contribute significantly to brain diseases, such as Alzheimers and vascular dementia. It’s very easy to have too much glucose in the blood when food choices are consistently overly high in carbs, especially simple carbs, compared to the other macronutrients and fiber. Normally a well-oiled machine, too much easy carb energy really messes with how our bodies manage our blood glucose levels. The Sweet Spot (haha - see what I did there?) At this point you may be wondering how to use carb-rich foods so that you have the Goldilocks amount that keeps you feeling great.
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Ten bucks says you are confused about how to include fats and oils healthfully in your food choices. Am I right? Folks of a certain age especially grew up being hammered with the “necessity” of eating low or no fat foods in order to have healthy arteries. And it just ain’t so. Let's talk about it! In Wellness, Mary Virginia Fats and Your Body Believe it or not, oils and fats are hugely important to how your body functions. These are some reasons your body will be glad you ate them:
I bet you have questions... Fat Makes You Fat, Right? Nope. In fact, balanced well with protein, complex carbohydrates, and fiber in a food plan using foods that have no or limited processing, health supportive fats and oils very much support the size your body wants to be. In the 1950’s a physiologist named Ancel Keys brought scientists together to perform a huge research program called the Seven Countries Study on the effects of diet on cardiovascular health and longevity. Yadayadayada…the results got limited interpretation by folks not part of the study, so our understanding devolved into a highly oversimplified popular belief that dietary fat was bad for you, i.e. it made you fat and clogged your arteries. By the 1970’s, as growing commercial food manufacturers began to crowd grocery store shelves, low- and no- fat products dominated the market based on this misunderstanding. Anyone remember Snackwells? The rich flavor of fats was replaced by the thin flavor of sweet. We found ourselves increasing our carbohydrate and sugar intake to support taste satisfaction and energy levels. Our bodies don’t know what to do with such an excess of foods that spike blood sugar. This shift in our food messed with our metabolism, cardiovascular health, and waistline. Dietary fats and oils contain 9 calories per gram, compared to 4 calories per gram in carbohydrates and protein. Typically the fats we eat are first utilized for all of the health benefits described at the start of this article, including our energy production. Only then is any excess stored as adipose tissue (aka, fat). But then there’s this: Picture yourself eating a higher fat meal - a drizzle of olive oil on your veg, a pat of butter on your sweet potato, some delicious chicken thighs... How well do the flavors satisfy your palate? How quickly do you feel full? How long do you feel full afterward? Fat/oil (along with protein and fiber) is very slow to digest, and therefore meals that include some fat/oil satiate us more quickly and keep us feeling full longer than low fat meals. It adds flavor and enhances mouthfeel, which increases our pleasure. While fat/oil might have more calories per gram, we tend to eat relatively small amounts of it (many fewer grams) in proportion to the rest of our food. Its long-lasting satiating effect leaves us feeling nourished until it’s time for our next meal. Well-managed moderate to higher fat food plans may have the effect of reducing adipose tissue (fat stores), even without pursuing ketogenesis (where fat is actively used for energy in place of glucose). Getting the balance right is imperative, so work with a nutritionist, most especially if you choose a ketogenic food plan. Note that for most people, ketogenesis is best used short term therapeutically, not as a full time forever way of eating. Adipose tissue accumulation (getting fat) or sustainably making the body smaller is not at all straightforward - it’s never, ever as easy as “calories in, calories out.” Don’t let anyone persuade you of that. It’s a total lie. The nutrient density of our foods, stress resilience, generational and personal trauma, hormone status, health status, digestion, medications, life stage, movement, sleep, mood, and the body’s natural preference all intricately contribute to body size way beyond merely the number of calories. Frankly, not eating enough calories can ultimately lead to a bigger body. This is where learning how to read your body and eat intuitively proves crucial. What’s the Deal with Saturated Fat? I remember years ago when my brother sent me a New York Times article that declared that saturated fat was safe to eat. “Now what am I supposed to do?” he lamented. This was news to him—and to a lot of people! Back to the popular understanding, everyone “knows” that saturated fat will cause a rise in total cholesterol and “bad” LDL cholesterol. What a relief to find out, then, that daily dietary saturated fat from healthy sources is not only unlikely to affect your arteries, but can contribute to better health? Check out this recent “well-done randomized controlled trial” (per Dariush Mozafarrian of Tufts University) from the University of Cambridge that describes that both butter and coconut oil do not cause the “bad” LDL cholesterol to rise and does increase good “HDL” cholesterol. The data for saturated fat and cardiovascular health is so interesting. For example, I provide this list of standard blood work to consider when you want a deep dive into your health status and risks. On that list are several tests for types of cholesterol. It turns out that including some saturated fat may have a beneficial effect on certain types of cholesterol (e.g., see LP(a) on that list). The upshot? Balance and food choices are key. Most interesting to me is that how our individual health responds to saturated fat has a strong genetic component. There are those who really do need to reduce saturated fat intake in order to protect their blood vessel, heart, and brain health. And there are those who actually need to increase their saturated fat intake. This can be determined by a 3x4 Genetics test (my code is MCOF001 when you register your kit. I can interpret your results and support you to better health using them). Here’s your reminder that good quality saturated fat in the diet also supports cellular health, mitochondrial health, and brain health. Ghee and butter even contribute to the health of your intestinal wall and a better mood. That doesn’t mean you should eat a vat of butter every day! But some saturated fat daily via real, whole food is health supportive for most people. Where will you find saturated fats? Butter & ghee, coconut oil, MCT oil, full-fat dairy (milk, cream, ice cream, sour cream, cheese), processed & cured meats (bacon, sausage), fried foods, meat (beef, pork), poultry dark meat, processed snack foods, and baked goods & pastries. Some of these have strong inflammatory effects, so eat the following rarely: processed/cured meats, fried foods, fatty cuts of meat, sugary foods, processed snack foods, and baked goods & pastries. Surely You Have Nothing Nice to Say About Trans Fats You’re right. I don’t. And don’t call me Shirley. By now we are all aware that trans fats cause damage: heart disease, cancer, diabetes, allergy, and more. These are a type of unsaturated fatty acid that absolutely clogs arteries and causes nearly 300,000 deaths annually. Unlike saturated fats, there is no healthy level of trans fats. That said, if you have a healthy body and you eat them very rarely (movie popcorn? potato chips? crackers?) your body will be able to clear them. Avoid them, though, if you have a higher risk or a disease diagnosis. Trans fats are found in industrially made products, such as margarine, shortening, fried foods, and many commercial baked goods and snack foods. One way to ID it on a label is to look for partially hydrogenated oil (PHO). What About Cholesterol in Food? Normally consumed amounts of dietary cholesterol, like what’s found in eggs, shellfish, or red meat will not cause your bodily cholesterol levels to rise. Cholesterol balance and heart health risk are most affected by: refined carbohydrates and sugars (i.e. blood sugar status); oils that contribute to inflammation (see below); high intake of saturated fats; digestive health (esp. constipation); and hugely affected by stress - both physical and mental. There can also be a familial (genetic) risk of high cholesterol that is also still not affected by dietary cholesterol. Hormone changes that come with age also increase bodily cholesterol. Sex hormones are made from the cholesterol made by your liver, so when that stops then cholesterol rises. There is some evidence that well balanced higher cholesterol levels are actually brain protective as we age. Should We Lean into Poly- & Mono- Unsaturated Fats? I won’t argue with you about the value of these flexible unsaturated fatty acids. They do indeed support healthier blood vessels, less sticky blood, and lower LDL and triglycerides. The place to be cautious, though, is with some cooking oils that are touted for their supposed heart-healthy benefits because they are high in polyunsaturated fats, such as soy, corn, canola, safflower, sunflower, and “vegetable” oils. These highly refined seed oils are deodorized and bleached to promote shelf life, stripping away all other potential nutritional benefits. Moreover, they are high in inflammatory omega-6 fatty acids. A diet that is rich in these oils will contribute to poor health. Ideally we’d consume a ratio of 1:1 omega-6 to omega-3 (anti-inflammatory) fatty acids via food, fats, and oils. However, Americans eat more like a 10:1 ratio! This contributes to the chronic inflammation that we see in heart disease, arthritis, depression and other mood disorders, gut disease, brain diseases, and other illnesses. → The most health-promoting cooking oil sources of poly- and monounsaturated fats are found in extra virgin olive oil and avocado oil. ← Scroll to the bottom of the newsletter for a primer on reaching this 1:1 ratio! Whew! That Was A Lot to Take In Many of my clients are surprised to learn that I actually encourage them to include oils and fats in their cooking! Given the health benefits and pleasures of good quality oils and fats, I would be doing them a disservice by not promoting them. One aside: if you don’t feel well when you eat fats and oils, you may have trouble digesting them. There are several possible reasons, from a sluggish gall bladder to no gall bladder to low digestive enzymes or stomach acid. Your friendly clinical nutritionist (me!) can help you digest them well again. I hope you’ll save this newsletter for reference, check out the fats & oils primer below, and please reach out with your questions! How to Include Healthy Fats & Achieve the 1:1 Ratio Cook at home most of the time
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AuthorI am Mary Virginia Coffman (I go by “Mary Virginia”), a clinical nutritionist who focuses on mental health, digestive health, metabolic health, and nervous system regulation. My unique combination of clinical interventions, education, and coaching will help you feel well in body, mind, and spirit. Archives
October 2024
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