Retrospective #315: “Carbohydrates and Sugars” Redux

When Type 2 Nutrition #31, “Carbohydrates and Sugars,” was originally published in 2011, it was an instant hit, now with almost 10 thousand pageviews. 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 again. 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, Type 2 Diabetes and its precursors, Pre-Diabetes and Insulin Resistance, and have discovered that all of these conditions are dietary diseases. 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 genetic “expression” in those who eat it and are so predisposed. So far, this affects about half the U.S. population.

One “expression” of this metabolic dysfunction is the associated development of fat accumulation in about 80% of Type 2s and Pre-diabetics. 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 opposite is true. The cause of obesity in Type 2s is Insulin Resistance (IR), the medical condition that develops and is the cause of Type 2 Diabetes and Prediabetes. The actual mechanism is described in Retrospective #308 and again in Retrospective #313.

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. Starting in 1977 our government has been recommending that we eat a diet that is 60% carbohydrate, 10% protein and 30% fat!  See the Nutrition Facts panel on processed food packages and do the math yourself. You should know now that it is not in your best interests to follow these recommendations.

So, if you’re going to eat fewer carbohydrates, it’s necessary to know something about the macronutrient 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, ALL carbs ALL become 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 all 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 and stored as glycogen. When the liver stores are full, these sugars are converted by de novo lipogenesis to fat. Repeated slugs of liquid sugar hitting a full liver can ultimately lead to “fatty liver disease.” All fruit juices and sugary soft drinks are such sugar “slugs.”

4) Complex carbohydrates are comprised of long chains of single 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 glucose molecules linked together. 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. 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, a highly refined carbohydrate. When carbs are “processed,” these “complex” foods break down easily to “simple” sugars.

And if you have Insulin Resistance, your blood sugar will remain elevated and be harmful to your health. Just remember: If you are Insulin Resistant, you are Carbohydrate Intolerant. Type 2 Diabetes is a Dietary Disease.