Sugars and Carbohydrates

psr

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Hi I have recently been diagnosed as being diabetic, and am finding the information that I am receiving from various different sources very confusing and was hoping that somebody may be able to help me clarify this particular point that is my latest confusion, I saw a dietician at my local doctors soon after I was diagnosed around 3 months ago That told me to take note of the labels on food in particular the amount of sugar that is released from the carbohydrates per 100g ,They gave me a chart that shows what is considered to be Low sugar ( below 5g per 100g / Medium ( between 5 - 15g per 100g ) and high (15g and over)
So I have been focusing on trying to consume foods that fall into the low category and not paying much attention to the actual count of carbohydrates per 100g thinking that if they don't sugar then I don't need to worry about them, However I have now started a 6 week awareness course at a specialist clinic run by the local health authority and have been led to believe that all carbohydrates will turn to sugar making my previous system and advice redundant , This means that I would be better of eating Doritos with 55g or Carbs per 100g than Ryvita with 66g per 100g .So In summary my question becomes ,Is it the total carbs per 100g or just the (of which sugars) that is important ? or is it both
 

douglas99

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Both are true.
All carbs turn into sugar.
However, sugar is an instant hit to your bs, so low sugar means you will avoid a spike.

However, the rate at which carbs change to sugar varies, from things like white flour bread, which is nearly instant, to things like burgen soya and linseed, which is slow.

Low GI food, is a better option then.
It also varies from person to person. Although there may be more carbs overall in Ryvita, I eat it as I know I digest it slowly. Doritos I digest faster, so a bigger rise in my bs.

So, avoid sugars is always good initial advice, but then eat lower GI foods if you eat carbs, (I do) but it's more important to test yourself with a meter to get a list of "good" foods you can manage.
 
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xyzzy

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It's the total carbohydrate count that matters. A simple rule of thumb is to start being increasingly wary of foods that are more than about 10g per 100g. You'll find the worst offenders are anything with sugar but also just as bad as sugar is anything very starchy so white rice, white pasta, mashed potatoes, white bread and other things made of flour. Even if you pick the brown versions they are still relatively high carb and although they wont spike your sugars quite as badly as the white processed versions you will still likely need to restrict how much of them you eat.
 
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xyzzy

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Low GI food, is a better option then.

Yes but early on in T2 diagnosis simply reducing total carbohydrates is far more effective. Low GI / GL is a good but secondary tool imo once you've gained experience and good control of your BG's. At best research by the ADA (in their annual position statements and accepted here in the UK) shows low GI alone for non insulin dependent T2's can reduce hBA1c by around 0.5% on average. This is nothing like the many percentage points drop that a good deal of newly diagnosed T2's can obtain be simply restricting total carbohydrates.
 
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xyzzy

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I had a look at that and it seems to be quite high carb

Yeah but the ADA is always pretty schizoid with it carb recommendations. They show quite high carb meal plans but then in their own latest position statement (page S23) on T2 state

It should be noted that the RDA for digestible carbohydrate is 130 g/day and is based on providing adequate glucose as the required fuel for the central nervous system without reliance on glucose production from ingested protein or fat.

see http://care.diabetesjournals.org/content/36/Supplement_1/S11.full.pdf for the 2013 position statement in full. That 130g recommendation has been unchanged for several years now.

The 130g recommendation equates to a 25% carb regime and matches in with their "quarter plate" advice given as the equivalent of the UK's Eatwell Plate nonsense guidance for T2's. The Eatwell plate of course advices double that i.e. 50% carbs.
 
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catherinecherub

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Hi psr,
Welcome to the forum.

It is confusing when you are first diagnosed and get conflicting advice and a flurry of posts that may be meaningless to you at this stage.

Your best way is to read this introductory post,
http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/
and ask for a meter from your G.P.or buy if you are refused and test your meals. You will soon learn which foods you can or cannot tolerate. It may be that some carbohydrate foods have to be eaten in smaller portions or banned from your diet. You can only guesstimate what is going on without a meter.
You have to find a way forward that you are comfortable with and all the advice that people give you may or may not be relevant. Nobody else can tell you what is right for you, only what is right for them. If only there was a blueprint diet that existed.
Read posts that are helpful to you and use your meter to devise a plan that you can tolerate.
Remember that you are changing your habits and this has to be a new way of eating. Don't look upon it as a diet because you will get fed up with it. Eat what suits your meter and your palate.
Once you get the hang of testing you will find that things become clearer.

Hope this helps,

CC.
 
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Daibell

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I agree with Catherine. The important thing is not to find a 'diet' but adjust your meal plans on a long-term basis that allows your blood glucose to come into a good range on your meter. Most of us have to move the carbs downwards and your meter will tell you by how much
 
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douglas99

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Yeah but the ADA is always pretty schizoid with it carb recommendations. They show quite high carb meal plans but then in their own latest position statement (page S23) on T2 state



see http://care.diabetesjournals.org/content/36/Supplement_1/S11.full.pdf for the 2013 position statement in full. That 130g recommendation has been unchanged for several years now.

The 130g recommendation equates to a 25% carb regime and matches in with their "quarter plate" advice given as the equivalent of the UK's Eatwell Plate nonsense guidance for T2's. The Eatwell plate of course advices double that i.e. 50% carbs.

"It should be noted that the RDA for
digestible carbohydrate is 130 g/day and is
based on providing adequate glucose as the
required fuel for the central nervous system
without reliance on glucose production
from ingested protein or fat. Although
brain fuel needs can be met on lower
carbohydrate diets, long-term metabolic
effects of very low-carbohydrate diets are
unclear and such diets eliminate many
foods that are important sources of energy,
fiber, vitamins, and minerals and are important
in dietary palatability (144).
Saturated and trans fatty acids are the
principal dietary determinants of plasma
LDL cholesterol. There is a lack of evidence
on the effects of specific fatty acids
on people with diabetes, so the recommended
goals are consistent with those
for individuals with CVD."

RDA is also the minimum , so at least 130g of carbs a day.
But always carbs to your meter.
 

tonyS54

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The ADA may indeed have recommended 130g from carbs but they still have a starting point of 45-60 grams a meal. They do add work with your health care teams to work out the right amounts but on reading around American forums dieticians much like many here still push the high carb low fat diet.. I know it's not a myth that whole grain breads, cereals, pasta, rice and starchy vegetables push my BGs high even in small portions

Myth: If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta.

Fact: Starchy foods can be part of a healthy meal plan, but portion size is key. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. Wondering how much carbohydrate you can have? A place to start is about 45-60 grams of carbohydrate per meal, or 3-4 servings of carbohydrate-containing foods. However, you may need more or less carbohydrate at meals depending on how you manage your diabetes. You and your health care team can figure out the right amount for you. Once you know how much carb to eat at a meal, choose your food and the portion size to match.

http://www.diabetes.org/diabetes-basics/myths/?loc=rp-slabnav


 

paul-1976

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"It should be noted that the RDA for
digestible carbohydrate is 130 g/day and is
based on providing adequate glucose as the
required fuel for the central nervous system
without reliance on glucose production
from ingested protein or fat. Although
brain fuel needs can be met on lower
carbohydrate diets, long-term metabolic
effects of very low-carbohydrate diets are
unclear and such diets eliminate many
foods that are important sources of energy,
fiber, vitamins, and minerals and are important
in dietary palatability (144).
Saturated and trans fatty acids are the
principal dietary determinants of plasma
LDL cholesterol. There is a lack of evidence
on the effects of specific fatty acids
on people with diabetes, so the recommended
goals are consistent with those
for individuals with CVD."

RDA is also the minimum , so at least 130g of carbs a day..

Goodness gracious me! I shall now go with the RDA and when my control goes for a Burton then at least 'Uncle big pharma' will have the answer to my ailments! :banghead:
 
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tonyS54

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Saturated and trans fatty acids are the
principal dietary determinants of plasma
LDL cholesterol

That should read trans fatty acids are the principal dietary determinants of plasma LDL cholesterol, as usual when low carb is mentioned sats and trans fats are lumped together. In my experience of four years of HF/LC saturated fat has had no effect on LDL
 
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xyzzy

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"It should be noted that the RDA for
digestible carbohydrate is 130 g/day and is
based on providing adequate glucose as the
required fuel for the central nervous system
without reliance on glucose production
from ingested protein or fat. Although
brain fuel needs can be met on lower
carbohydrate diets, long-term metabolic
effects of very low-carbohydrate diets are
unclear and such diets eliminate many
foods that are important sources of energy,
fiber, vitamins, and minerals and are important
in dietary palatability (144).
Saturated and trans fatty acids are the
principal dietary determinants of plasma
LDL cholesterol. There is a lack of evidence
on the effects of specific fatty acids
on people with diabetes, so the recommended
goals are consistent with those
for individuals with CVD."

RDA is also the minimum , so at least 130g of carbs a day.
But always carbs to your meter.


...and your point in quoting the whole paragraph is what?

The point I was trying to make is that the ADA advice makes no sense.
It does not say its a minimum it says the RDA is 130g. So on a 2000 calorie average persons intake roughly 25% should come from carbs. That's fine if your meter says it works for you.

So if you recommend a 25% carb regime that means 75% must be coming from protein and fat full stop. The RDA for protein is around 16% which many people (including me) exceed and end up somewhere between 20 and 30%. Let's call it 30% meaning the difference leaves 45% as fat. What is that if not a low carb high fat recommendation that so many of us follow and have found so beneficial.

There is no such thing as a low carb low fat low protein diet. That's the myth!

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douglas99

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That should read trans fatty acids are the principal dietary determinants of plasma LDL cholesterol, as usual when low carb is mentioned sats and trans fats are lumped together. In my experience of four years of HF/LC saturated fat has had no effect on LDL

No, the quote is correct as written.
 
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mrman

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...and your point in quoting the whole paragraph is what?

The point I was trying to make is that the ADA advice makes no sense.
It does not say its a minimum it says the RDA is 130g. So on a 2000 calorie average persons intake roughly 25% should come from carbs. That's fine if your meter says it works for you.

So if you recommend a 25% carb regime that means 75% must be coming from protein and fat full stop. The RDA for protein is around 16% which many people (including me) exceed and end up somewhere between 20 and 30%. Let's call it 30% meaning the difference leaves 45% as fat. What is that if not a low carb high fat recommendation that so many of us follow and have found so beneficial.

There is no such thing as a low carb low fat low protein diet. That's the myth!

Sent from the Diabetes Forum App

Thats the problem. People take average and think it means them. What do they class as average. Obviously average height/weight/age/activity etc
If 2000 is average and a person is shorter than average then deduct some calories off the 2000. Take a few more off if a bit older, some more if you do less activity than average, you soon end up with many more less calories than recommended. Who's fault, personally I think its the nhs or whoever comes up with these rather than sitting down with an individual and working out with them a suitable diet based on them. Google can do it. Many people on the average intake of food groups are already over/under eating to begin with, whilst following said guidelines.

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xyzzy

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Thats the problem. People take average and think it means them. What do they class as average. Obviously average height/weight/age/activity etc
If 2000 is average and a person is shorter than average then deduct some calories off the 2000. Take a few more off if a bit older, some more if you do less activity than average, you soon end up with many more less calories than recommended. Who's fault, personally I think its the nhs or whoever comes up with these rather than sitting down with an individual and working out with them a suitable diet based on them. Google can do it. Many people on the average intake of food groups are already over/under eating to begin with, whilst following said guidelines.

Sent from the Diabetes Forum App

Yes I agree entirely that treatment should be done on an individual basis but of course it's not really much good if the advice people get is bad to begin with or outdated etc.

Again I am not pushing any kind of diet just trying to show that if as the ADA do recommend a 25% or quarter plate regime then 75% must be coming from a combination of protein and fat and that therefore their low fat stance is effectively just words and has no basis in science.

They cannot have it both ways.

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xyzzy

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Alternatively you can read the ADA recommendations as pushing a low fat diet but then it makes a nonsense of advocating a 25% quarter plate carb policy ...

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smidge

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I agree with a lot of what's been said here, but psr is already confused with the conflicting advice he's received so discussions of this type would be better in a different thread in my opinion.

The short answer to the question asked is that ALL carb turns to sugar in the blood so it is the TOTAL CARB figure that is important when reading the food labels.

Smidge
 
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