Type 2 Diabetes, a Dietary Disease #315: “Carbohydrates and Sugars” Redux

In “The Nutrition Debate,” the precursor blog to this series, column #31 (out of 305), “Carbohydrates and Sugars,” had many thousands of hits. And since my new emphasis is on the recently diagnosed Pre-Diabetic and Type 2 Diabetic, demystifying carbohydrates and sugars is a good place to start. So, let’s get down to basics.

The premise for educating the reader about carbohydrates, including sugars, is that you have independently researched the medical condition, T2DM, and its precursors, Pre-Diabetes and Metabolic Syndrome, and the “history” of how these conditions develop, and have concluded, that all of these conditions are dietary diseases. It is still something of a mystery that not everyone who eats the Standard American Diet (SAD) develops them, but it is widely accepted that 1) a genetic predisposition is required and 2) that the SAD triggers a metabolic “expression” in those who eat it and are so predisposed. Today, this affects about a third of the U.S. population.

One “expression” of this metabolic dysfunction is the associated development of obesity. In fact, they are so closely related that the word “diabesity” has been coined to link them. Most medical sites actually cite obesity as a “cause” of diabetes. That is simply wrong. In fact, the exact opposite is true. The principal cause of obesity is Insulin Resistance (IR), a medical condition that develops and underlies Type 2 Diabetes and its precursor conditions. The actual mechanism is described in #308 here and again in #313 here.

So, what is the SAD? According to Wikipedia, “The typical American diet is about 50% carbohydrate, 15% protein, and 35% fat. Are you surprised? You shouldn’t be. For over 35 years our government has been urging us to eat a diet that is 60% carbohydrate, 30% fat and 10% protein! And it still does! Check out the Nutrition Facts panel on processed food packages and do the math yourself. Your government has been leading you down this primrose path. And these guidelines, including the 2015 Dietary Guidelines for Americans released last month, still lead us on this misguided path. You, I presume, have concluded that it is no longer in your best interests to follow them.

So, if you’re going to eat fewer carbohydrates, it’s necessary to know something about the nutrient composition of food. All foods are composed of protein, fat and carbohydrates. Period. (Alcohol is not a “nutrient.” LOL)

1) All carbohydrates are saccharides; that’s Latin for “sugars.” For nutritional purposes, they are divided into two broad classes: simple sugars and so-called “complex” carbohydrates. In the blood, they are all called glucose.

2) Simple sugars are further divided into compounds of one or two molecules (monosaccharides and disaccharides). Examples include sucrose (table or cane sugar, a disaccharide composed of one molecule each of glucose and fructose). It is the same disaccharide sucrose found in fruit, together with the monosaccharides free glucose and free fructose. Sugar in fruit has the exact same effect on your blood sugar as table (cane) sugar.

3) Disaccharides break down quickly and easily into glucose and another monosaccharide. The glucose circulates in the bloodstream until it is absorbed by receptor cells. Excess glucose is returned to the liver for storage. When the liver stores are full, these sugars are converted by lipogenesis to fat. Repeated slugs of liquid sugar hitting a full liver can ultimately lead to “fatty liver disease.” All fruit juices and soft drinks are such “slugs.”

4) Complex carbohydrates are comprised of longer chains of just glucose molecules. They are divided into two classes: oligosaccharides comprised of 3 to 10 glucose molecules linked together, and polysaccharides, comprised of more than 10 molecules of just glucose. Examples are all starches (breads, cereals, potatoes, rice and pasta).

5) The so-called complex carbohydrates are commonly (and erroneously) thought to be better dietary choices than simple sugars. In my view, that’s like saying arsenic is better for you than cyanide because it works more slowly. Remember, bread is how the glycemic index is defined. It has an “index” of 100. After highly processed and “refined” (more aptly “stripped”) white flour, and water, the third ingredient in every loaf of bread is some form of added sugar. And sprouted (malted) grains only mean that the process of breaking down those grains to glucose and other “sugars” began at the bakery. By processing, the “complex” food becomes “simple” sugars.

6) While some chains of glucose in whole, unprocessed foods take a little longer than processed ones to be digested by enzymes, remember a) they are all glucose molecules and b) all glucose in your blood will raise your blood sugar. And if you have Insulin Resistance, your blood sugar will remain elevated and be harmful to your health. Just remember: If you are IR, you are Carbohydrate Intolerant. Type 2 Diabetes is a Dietary Disease.