Author: Heather K. Mackie, MS, RD, LD Week of October 15, 2012 Many patients are concerned about carbohydrates related to health and weight loss and have heard carbs are bad.  But what is the truth about our starchy friends???  This blog will define carbohydrates, explore the role of carbohydrates, the amount of carbohydrates one should consume per day, and which carbohydrates are best for us. What is a Carbohydrate? Broken down, carbs are long strands of sugar molecules linked together.  Some strands are only a few molecules, while other strands might be thousands of strands.  Our digestive system breaks down all carbohydrates into individual sugar components to make them small enough to cross into our bloodstream.  Smaller carbohydrate strands are often referred to as simple carbohydrates.  This is because they are more easily digested (broken down quicker) into individual sugar molecules.  Longer carbohydrate strands are termed complex carbohydrates.  This is because they take longer to breakdown (more difficult to digest). Another type of carbohydrate includes fiber.  Fiber is naturally found in plant sources, like whole grains, fruits, vegetables, and beans.  Fiber cannot be digested by the body and therefore helps to eliminate waste and assist in maintaining intestinal tract health. Role of Carbohydrates. Carbs provide energy (fuel for muscles and our nervous system), as well as, provide dietary fiber.  Carbohydrates are the main source of energy for the human body and are important for proper functioning of many systems and tissues in the body.  Every tissue and cell in the body uses glucose (a form of sugar, also known as a carbohydrate) for energy.  This energy can be used immediately as soon as the carb is digested and glucose sugars are sent to the bloodstream.  This energy can also be stored within our muscles and liver for the future.  Carbs also work to regulate our digestive system and maintain intestinal health (via fiber). How Many Carbohydrates per Day? According to the USDA Dietary Guidelines, 45-65% of your daily calories should come from carbohydrates.  The list of carbohydrates may include: grains, potatoes, pasta, fruits, veggies, beans, soda, candy, desserts, etc.  However, it is recommended that the majority of your carb intake come from complex carbohydrates (see below) since they take longer to digest.  If you take the average American recommended diet of 1800-2000 calories per day, this would equate to 200-325 g carbohydrates per day. It has been recommended by some professionals that individuals need at least 100-150 g per day for optimal brain function and to prevent muscle wasting. How Many Carbohydrates for a Bariatric Patient? Obviously, most bariatric patients are not consuming 1800-2000 calories per day.  I read one article that stated the average caloric intake of gastric bypass patients 3 years post-operatively was 1300 calories per day.  I know every patient is different, but long-term I think the same percentage range can apply to bariatric patients (possibly on the lower end of the range, closer to 45% of your calories).  Long-term patients can start tolerating some complex carbohydrates including grains, fruits and veggies.  If we take a range of 1000-1500 calories per day, that would equate to 113-250 g of carbohydrates per day.  While the latter number might be considered high it is still not what the average American is consuming, but is still meeting the minimum amount needed per day for optimal brain function and to prevent muscle wasting.  Keep in mind though, if you are still early post-op (less than 12 months), then you may not be meeting this goal.  In the beginning stages it is going to feel like all you are eating is protein, because that is all there is room for, but as you are able to eat more and tolerate more foods, you should be incorporating more fruits, vegetables, and whole grains as recommended by your dietitian and/or surgeon. Keep in mind if you are exercising, you need enough carbohydrates to get through a good workout.  If you feel run down and are not able to finish your workouts it is possible you are not getting enough carbs – talk to your dietitian to make a plan that will promote weight loss and give you enough energy to get in good, quality exercise sessions. Are All Carbs Created Equally?Not all carbohydrates are the same.  Many people already know the answer to this question, but let’s review.  Sometimes you will hear the term “good” carbs versus “bad” carbs or “complex” carbohydrates versus “simple” carbohydrates.  What does this mean?

  • Good/Complex Carbs. Some examples of “good” carbohydrates would include: whole grain cereals, whole grain breads, brown rice, corn/whole wheat tortillas, low-fat dairy products, oatmeal, barley, whole wheat pasta, sweet potatoes, and any bean.  Other complex carbs include fruits and veggies.    These foods will provide energy, while also providing fiber, vitamins, minerals and other helpful compounds to your body.  Another benefit of complex carbs is they are typically tolerated better in weight loss surgery patients.

  • Bad/Simple Carbs. Some examples of “bad” carbohydrates would include: candy, pastries, sugar-sweetened soda and/or sweet tea, other sugary desserts, white rice, white bread, white pasta, white potatoes (there is a theme here – white foods).  Just because we are calling these “bad” carbohydrates doesn’t mean you can’t ever have them.  Try consuming these foods in moderation or only on occasion.

  • For example, apples are a complex carbohydrate.  They take longer to be broken down and contain dietary fiber.  However, they also contain sugar, roughly 3 tbsp. of sugar for your average apple.  However, eating 3 tbsp. worth of sugar from candy corn (sorry – it is Halloween season) is not going to react the same in your body.  Candy corn is a simple sugar.  They will break down quickly, enter the bloodstream quickly and give you a quick BOOst (get it – haha) of energy.  But once those quick sugars are used up, your blood sugar will drop and you will quickly feel that “carb coma.”  Eating an apple will make you feel a lot better – the sugars from the apple are complex and will take longer to breakdown.  They will enter the bloodstream and you will get a boost of energy, but not the dramatic high’s and low’s that you get from candy since fiber is also included in this food item.

Carbohydrate Conclusion. It has been well studied that diets low in fiber can cause constipation and hemorrhoids, as well as increase the risk for certain cancers.  Oppositely, diets rich in whole grains instead of refined grains and simple sugars, has been shown to lower cholesterol, reduce ones risk for obesity, and chronic diseases such as heart disease, type 2 diabetes, and high blood pressure.  So don’t be scared of carbs!  Know which ones to choose and eat them in moderation and continue to CELEBRATE your success!