Part 1 – Do We Really Need 130g of Carbohydrates Per Day?

If you are a diabetic and have been told you HAD TO have 130g of carbs per day...ever wonder where that number came from?

You may have been taught that the body needs a minimum of 130g per day of carbohydrates to function, particularly, that this amount of carbohydrate is needed for brain function.  This is simply not true.   In fact, would you be surprised to know that there is NO essential level of carbohydrates in the diet?  Yes, the body needs some glucose, but it DOES NOT need carbohydrates to supply that glucose.  The body is perfectly capable of producing all of the glucose it needs through gluconeogenesis.  The body can also use fat as an alternative fuel source.

Dr. Mark Hyman, nationally renowned MD, Founder of the Ultra Wellness Clinic and Head of Functional Medicine at Cleveland Clinic,  has stated the following:

“You may not know this, but the body could survive without carbohydrates. Our bodies require essential amino acids to build proteins and essentially fatty acids to function properly – yet there is no such thing as an “essential” carbohydrate. At the same time, nobody would contest the nutritional value of plant-based carbohydrates. However, if you never ate another carbohydrate again in your life, you would survive!”

So how was this number (130g) derived?  This number was recommended in the publication “Dietary Reference Intakes for Energy, Carbohydrate, Fiver, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (Macronutrients)”, published by the National Academics of Sciences, Engineering and Medicine (HERE).  However, even while making this recommendation, this publication it is candidly admits that “the lower limit of dietary carbohydrate compatible with life apparently is ZERO, provided that adequate protein and fat are consumed.”  It acknowledged that “there are traditional populations that ingested a high fat, high protein diet containing only minimal amount of carbohydrate for extended periods of time, and in some cases, for a lifetime after infancy.  There was no apparent effect on health or longevity.”  It mentioned that people “eating an essentially carbohydrate free diet…tolerated the diet quite well.” (page 275)  It states that the “minimal amount of carbohydrate required…is determined by the brain’s requirement for glucose.”  It goes on to say that the brain is the only true glucose dependent organ, but that “even the brain can adapt to a carbohydrate-free, energy sufficient diet.” (page 277)  It goes on to explain how ketoacids can suppy approximately 80% of the brain’s needs, thus the brain only requires 22-28g of glucose to fuel itself.  Further, it states that “this required amount of glucose could be derived easily from ingested protein alone if the individual was ingesting a carbohydrate-free, but energy-adequate diet.” (page 279).  The publication admits on page 285 that the 130g recommendation was made so that the brain would derive all of it’s glucose needs from carbohydrates, rather than from protein, fat or ketone production any higher than as would be produced in an overnight fast (page 285), but summarizes by saying that “it should be recognized that the brain can still receive enough glucose from the metabolism of fat and from the gluconeogenic amino acids in protein when a very low carbohydrate diet is consumed.”  (page 289).

 (Interesting article HERE)

Does this mean that I PERSONALLY advocate NO carbohydrates?  Not at all!  As Dr. Hyman pointed out, no carbohydrates means no vegetables.  I personally don’t endorse that (although some live quite healthily without carbohydrates in their diets).  I appreciate the nutrients contained in some plant foods.  However, the amount and quality of the carbohydrates is extremely important.

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Let’s think about it this way.  If I were a person with lactose intolerance, would it make sense to center my diet around milk and cheese?  No, I would not be able to process these foods.  Very simply, diabetes is a disease of carbohydrate intolerance.  Why then, should a person with diabetes, center their diet around carbohydrates, when they are unable to process these foods efficiently?

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“Diabetes is a disease of carbohydrate intolerance. Reducing carbohydrates is the obvious treatment. It was the standard approach before insulin was discovered and is, in fact, practiced with good results in many institutions. The resistance of government and private health agencies is very hard to understand. For many people with type 2 diabetes, low-carbohydrate diets are a real cure. They no longer need drugs.   They no longer have symptoms. Their blood glucose is normal, and they generally lose weight.” – Barbara Gower, Ph.D., professor and vice chair for research in the UAB Department of Nutrition Sciences.
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So, how much carbohydrates should a person with diabetes eat?  There is no magical number.  Firstly, it is helpful to focus not only on the AMOUNT of carbohydrates, but the SOURCE of carbohydrates as well.  If  thinking only about watching the NUMBER of carbs eaten, we would be missing half the point. If a potential source of nutrients is going to be limited, it is important to focus not only on the QUANTITY but also on the QUALITY of carbs.
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Say for instance, we choose to eat 50g of carbs per day, but we “spend” them on bread and pasta. What would we be missing? A HUGE source of nutrients that could have been received from better quality carbohydrates. Choosing the most nutrient dense carbs available is key. Quality carbs are usually those found in nature, those which derive much of their carb content from fiber and those which have very little effect on blood sugar.  Good quality carbs are predominantly non-starchy vegetables, but also nuts and nut butters (in moderation), certain types of full fat dairy and some low sugar fruit (if tolerated). For those needing to improve blood sugar control, focusing on carb quality is extremely important, as poor quality carbs typically raise blood sugar significantly.  I always say, “a carbohydrate is not a carbohydrate.”  The body will react quite differently to 30g of carbs from REAL food versus 30g from fake, processed and refined, food-like products.   (See below).  So, that brings me to my first piece of advice to all people: EAT REAL FOOD.  What IS REAL FOOD.  My motto is, “if it can sit in a bag or a box on a shelf in the grocery store, and not spoil after a week, then it is not food.”  While there are exceptions to this rule (nuts, oils), for the most part, try to choose foods without nutrition labels.  If it DOES have a nutrition label, there should be less than a handful of ingredients.  You should be able to identify and pronounce each ingredient. 🙂
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That still doesn’t answer the question, “how much?”  That question is different for every person.  This is where my second piece of advice comes in: EAT TO YOUR METER.   Why?  Well, even if you are eating real food, there will be some foods that will raise your blood glucose to unsafe levels (examples: starches, grains, high sugar fruit, etc.)  Therefore, use your blood glucose meter to tell you how much carbohydrate to eat.  For instance, my blood glucose will raise significantly with a whole bowl of strawberries, but very little with three strawberries.  So, I have used my meter to help me determine my tolerance for foods that contain carbohydrates.
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To do this, test before you eat, and approximately 1 1/2 hours after you started eating.  If your blood sugars out of target range*, I suggest examining the meal just consumed, identify the carbohydrate portion of the meal, and decrease the size, or if you wish, eliminate that food.  I don’t like to tell people EXACTLY what and what not to eat within the guidelines of real food.  But I do want people to make their food decisions armed with knowledge.  If the food we are eating takes our blood sugar out of range, continuing to consume that food will require more medication and will progress diabetes.  In my opinion,  NO food is worth medication.  Medication comes with side effects.  And over time, medications become ineffective, requiring increasing doses or additional medications.
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*(normal fasting BG is below 90, normal post meal BG is below 110, 120 at the most.  I prefer to keep my BG under 100 post-meal to continue to keep my diabetes reversed.)
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What does monitoring the amount and quality of carbohydrates accomplish for people with diabetes?  For Type 2’s, many are able to reduce or eliminate medications.  This can actually help reverse the disease process, rather than progress it.  For Type 1’s, many feel that lowering carbohydrates means one will experience more hypoglycemic episodes.  In fact, it does just the opposite.  When a Type 1 reduces carbohydrates, they reduce insulin needs and therefore, reduce hypoglycemic episodes.
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Let me say that personally, I consume no more than 25-50g of carbs per day, all from unprocessed, whole foods, no processed foods.  I have done this for nearly five years.  (So if the 130g rule was true, I’d be brain dead by now…lol!)  This allowed me to completely reverse my pre-diabetes, and other health problems, as well as experience a weight loss of 80 lbs.   (Read my story under the “Start Here” tab above.)

For more information on Managing Diabetes with Lifestyle, click  HERE