The Catch to Carbs by James N. Dillard, M.D.

The Catch to Carbs

What are your favorite holiday treats? Sticky buns with pecans? Christmas cookies? The holidays come with cheesecake, pastries, pudding, rum cake, panettone, Yule logs, stockings full of candy, and the list goes on.

Most people love carbohydrate foods, from breads and pastas to sweets and desserts. Our bodies are built to love these things. Our taste buds are wired directly into the most powerful, primitive parts of the brain’s pleasure centers.  As soon as starch touches your mouth, an enzyme in saliva cleaves it directly into sugar. Who wouldn’t love carbs?

We’ve also known the feeling of overdosing on carbs or sugar. It’s not pleasant. And we’ve seen kids in sugar shock, blasting off higher than 10 lords a-leaping. Even worse, carbohydrate-rich diets can lead to diabetes, heart disease, obesity, infertility, macular degeneration, and even cancer.

Carbohydrates are clean-burning, efficient, and quick fuels for the body. That’s why they taste good to us — they equaled survival for hungry human tribes in lean times for millions of years, if you believe that sort of thing. The body burns them with only carbon dioxide and water as the by-products. And we can store them around our middles for later.

But as with fat and protein, there are good carbohydrates and bad carbohydrates. This whole subject is fraught with heaps of nonsense, from the no-carb, high-fat diets to high-carb, radical veganism. Let’s stay with how the body really works — this information can help keep you well.

There are simple carbohydrates, such as sugars, and complex ones, such as starch from inside a grain kernel.  Starch is just single glucose molecules (the simplest sugar) strung end to end like a railroad train. Starch can be broken down quickly by intestinal enzymes into glucose, and it can flood the blood with sugar all at once. These foods with much available starch and sugar have a high glycemic index.

The glycemic index just means that the food can raise your blood sugar level strongly and quickly. That gets insulin pumped out hard as a response by the pancreas. Insulin gets the sugar into the cells from the blood. With repeated high glycemic loadings over a long period of time, the body’s cells get more resistant to the effect of insulin. Eventually, depending on your genetics, you’re on your way to diabetes.

Second, and just as bad, when a flood of sugar hits your bloodstream it sticks onto proteins in the blood, turning them into advanced glycation end-products or AGEs (sorry, folks). These things literally age you. The sugar-glazed proteins are highly reactive and inflammatory, injuring vital tissues in your kidneys, eyes, nerves, blood vessels, and joints.

The best measure doctors have for your overall blood sugar control, the hemoglobin A1c, is actually just a measurement of another one of these sugar-coated proteins.  Excessive AGE formation has also been associated with age-related conditions, such as strokes, cataracts, and Alzheimer’s disease.

Authorities continue to recommend that you eat whole grains because they contain some healthy nutrients, but most of these foods are not whole. When folks are asked to name a whole grain food, most people say “whole wheat bread.” But most whole wheat breads are just white bread colored brown.  The whole grains have been cracked open, milled down to starch, and have a high glycemic index.

Once you mill a grain kernel to flour, you expose the starch inside into being an infinite surface area for our starch-busting enzymes. Those enzymes can chop up that starch in a heartbeat, dumping glucose into the bloodstream. With real whole grains you can see many actual whole grain kernels, or barely cracked kernels. So most bread is not very healthy.

I know this sounds like heresy, but a bowl of shredded wheat has a pretty high glycemic index and sugar-load on the blood. So does a stack of rice cakes or red-skinned potatoes.  And fat doesn’t make you fat — carbs make you fat.  A low-fat muffin with white flour and sugar will expand your waistline far more efficiently than whole grain oatmeal with butter.

For more on this, have a science geek get you a copy of a new article by Thomas M. Larson and colleagues in the Nov. 25 issue of The New England Journal of Medicine titled “Diet, Obesity, and Genes (Diogenes) Project. Diets with high or low protein content and glycemic index for weight-loss maintenance.” It will be an eye-opener for the conventional medical crowd.

Humans evolved traveling in tribes. They did not eat Boston cream pie or cinnamon rolls. They lived on greens, nuts, berries, seeds, eggs, tubers, beans, and natural seafood, meat, and fowl. It is a very low-glycemic diet that does not overchallenge insulin. It is still a good idea.

I don’t want to sound like the Grinch here, so please do indulge a bit over the holidays. Part of Aristotle’s “moderation in all things” is to occasionally be moderately immoderate. But these AGE proteins do serious inflammatory tissue damage, and consistently high insulin levels promote cancer and diabetes. A lower, healthy carbohydrate-eating plan is best.

On a larger scale, our best medical economists now tell us that rampant diabetes is likely to bankrupt the entire American health-care delivery system within 10 years if we do not make some big changes. The diabetes epidemic and the abuse of carbohydrates must be reversed for our very economic survival.

As for root causes, one only need follow the money. Profit margins rule for big subsidized agribusinesses, advertising sugary corporate pseudo-food to children, and for the latest $600 million diabetes drug. For Wall Street, it’s always about being up next quarter, just like your blood sugar, your bathroom scale, your insulin level, and the size of your tumor.

God rest ye, merry gentlemen.

Dr. Dillard is on the faculty at the annual University of Arizona Nutrition and Health Conference directed by Dr. Andrew Weil, now going into its eighth year.

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