Children Eat Their Weight In Sugar: What Can Be Done?

sugar-1482196Introduction

The first recommendations on carbohydrate intake were proposed in the 1980’s and 90’s by COMA which has since disbanded. Since then overwhelming evidence has mounted which shows carbohydrate consumption to be associated with many of today’s current health problems. More specifically, the type of carbohydrate and the consumption of simple sugars and refined carbohydrates has become an increasing concern. High sugar intake is implicated as a significant risk factor for diabetes, fatty liver disease and obesity and receives a large amount of focus for current health initiatives and government policy on the recommendations for sugar intake.

Prevalence of weight related disease

In the UK 57% of adults are overweight and obese which is predicted to reach around 70% by 2034 (Public Health England Obesity Knowledge and Intelligence team, 2016). Children in the UK are following a similar trend with 25% of them being over weight and obese. The prevalence of doctor-diagnosed diabetes in adults increased between 1994 and 2014 from 2.9% to 7.1% and 1.9% to 5.3% for men and women respectively. The cost of obesity to the NHS is £5.1 billion (Scarborough et al., 2011) and the cost of treating diabetes and the complications that result from it in 2010/11 was £9.8 billion a year which is projected to be over £16.9 billion by 2035/36 (Hex et al., 2012). However, the NHS has refuted claims about potential bankruptcy in the future (Nhs.uk, 2012) despite such claims circulating in the media (Google.co.uk, 2015).

Sugar consumption

Actual sugar consumption has fallen over the past 40 years while consumption of sugar-sweetened beverages and foods have risen. Children ages 4-10 are said to consume on average just over 60g of sugar a day, equating to 5,543 sugar cubes or 22kg of sugar in one year (Gov.uk, 2016). Sugar consumption is highest among school age children and low income families. However, a high consumption of sugary foods is not justified by a low income when you consider a bag of bananas or apples can be purchased at a lower price which contains natural sugars, as well as vitamins and minerals. The biggest source of sugar for kids are juices and soft drinks, although for ages 19-64 one of the biggest sources of sugar comes from table sugar. However, this may be attributed to Britain’s cultural obsession with Tea.

Parents perception of child weight status and health

The fact that 42% of parents do not recognise their children to be overweight or obese when they are (Public Health England, 2015) also contributes to the problem. A study showed parents of overweight and obese children considered happiness, diet and activity level to be more important than body weight as an indicator of health, despite the physical and mental health implications of being overweight or obese (Syrad et al., 2014). The same study found that parents also didn’t find the BMI scale to be a credible indicator of a child’s health, because according to parents it didn’t take into consideration the child’s lifestyle. This shows that despite the implicated health risks of being over weight or obese, parents do not acknowledge body weight to be a significant risk factor to their child’s health. This is a dangerous misperception that needs to be immediately corrected. A strategy to give parents a more accurate perception of ‘overweight’ as well as education on the diverse effects that being overweight or obese has on their children, must be part of the health initiative. Failure to do so will not address the wider context of the problem

Current health initiatives

Health initiatives are currently in place across Britain to reduce sugar intake.
Public Health England compiled an evidence based report called “Sugar consumption: The evidence for action” (Public Health England., 2015) which expresses the need to drastically reduce sugar intake across the population, which even the British Dental Association stated would be reckless to ignore (BDJ Team., 2015).
Change4Life has issued a new campaign that focuses on educating parents to be “sugar smart” and even encourages parents to download the new Sugar Smart app that measures the sugar content of every day food and drink (Nhs.uk., 2016).
Action on Sugar have also proposed an evidence based, six point sugar reduction plan to David Cameron (Cameron’s Plan: A comprehensive approach to prevent obesity, 2015) and are also backing TV chef Jamie Oliver’s obesity plan too (Actiononsugar.org, 2015). Some of the actions proposed by Action on Sugar involve a 50% sugar reduction within the next five years starting with soft drinks, ceasing the promotion and all types of marketing of unhealthy food to children and adolescents and a 20% duty on all sugar sweetened soft drinks and confectionery. They also began promoting sugar awareness week between the 30thNov-6thDec (Actiononsugar.org, 2015). All health initiatives proposed involve the proposal of a sugar tax with 53% of the public being for it.

Educational behavioural strategies

In review of five educational school intervention programmes that aim to reduce sugar-sweetened beverage consumption and investigate changes in body mass, three showed long term success (Avery et al., 2014). After 12 months, one of which found the percentage of overweight and obese children decreased while the control group increased by 7.5% (Stockman., 2006). Sugar tax doesn’t address the root causes or take into context the bigger picture. Research has also suggested calorie intake has dropped but activity levels have dropped further (Prentice et al., 1995). Evidence investigating marketing strategies such as the four P’s (promotion, price, product, place) framework is shown to influence consumption and purchase of sugar (Sugar Reduction: The evidence for action Annexe 3, 2015). These same principles can be applied to the marketing of healthy foods, but need to be marketed with equal if not more vigour than the marketing strategies used to promote unhealthy foods.

Conclusion

Overall the dynamics of sugar consumption and its effects on the health of the population is complex. As such, this surely warrants an equal response and an approach that mirrors it’s complexity. The food industry needs to become a part of the solution and not part of the problem to shift the favour towards the goals of the initiatives. Whilst the government needs to do its part in enforcing change and aggressively working towards fulfilling the goals of the initiatives. However, reducing sugar consumption is just one step towards tackling a multi faceted problem. There are many other factors affecting the health of the public besides sugar. Significant, long term improvements in public health and reductions in dietary related diseases will ultimately be accomplished at an individual level without tactics of coercion. This change will come from parents having; realistic nutrition and bodyweight perceptions, better food awareness, practical guidance on calorie balance and portion control and education on the effects of overnutrition. This all of course needs to be followed up with parents putting knowledge into practice and implementing long term positive behaviour changes such as moderating portion sizes or increasing purchases of foods that contain natural sugars such as fruit, whilst decreasing or eliminating the purchase of foods that contain ‘free sugars’.

References

Actiononsugar.org. (2015). ACTION ON SUGAR BACKS JAMIE OLIVER’S OBESITY STRATEGY AND LAUNCHES ITS OWN EVIDENCE-BASED ACTION PLAN TO SAVE LIVES AND THE NHS. [online] Available at: http://www.actiononsugar.org/News%20Centre/Press%20Releases%20/2015/167492.html [Accessed 17 Mar. 2016].

Actiononsugar.org. (2015). Sugar Awareness Week. [online] Available at: http://www.actiononsugar.org/sugar-awareness-week/Sugar%20Awareness%20Week%202015/167198.html [Accessed 15 Mar. 2016].

Avery, A., Bostock, L. and McCullough, F. (2014). A systematic review investigating interventions that can help reduce consumption of sugar-sweetened beverages in children leading to changes in body fatness. Journal of Human Nutrition and Dietetics, 28, pp.52-64.


BDJ Team (2015) 2, Article number: 15157. Ignoring Public Health England report on sugar reduction would be reckless. BDJ Team, 2(10), p.15157.


Butland B, Jebb S, Kopelman P. (2007).
Tackling obesities: future choices – project report 2nd Ed. London: Foresight Programme of the Government Office for Science, 2007.


Cameron’s Plan: A comprehensive approach to prevent obesity. (2015). [pdf]. UK: Action on Sugar. Available at: http://www.actiononsugar.org/News%20Centre/Press%20Releases%20/2015/167492.html [Accessed 16 Mar. 2016].

Google.co.uk. (2015). diabetes threatens bankrupt NHS UK 2015. [online] Available at: https://www.google.co.uk/gfe_rd=cr&ei=e3PpVo_DEenS8AesxIKIDg&gws_rd=ssl#q=diabetes+threatens+bankrupt+NHS+UK+2015 [Accessed 16 Mar. 2016].

GOV.UK. (2016). 5 year olds eat and drink their body weight in sugar every year – Press releases – GOV.UK. [online] Available at: https://www.gov.uk/government/news/5-year-olds-eat-and-drink-their-body-weight-in-sugar-every-year [Accessed 15 Mar. 2016].

Hex, N., Bartlett, C., Wright, D., Taylor, M. and Varley, D. (2012). Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine, 29(7), pp.855-862.

Nhs.uk. (2012). Massive rise in diabetes costs predicted – Health News – NHS Choices. [online] Available at: http://www.nhs.uk/news/2012/04april/Pages/nhs-diabetes-costs-cases-rising.aspx [Accessed 16 Mar. 2016].

Nhs.uk. (2016). Let’s get Sugar Smart! Download the Change4Life Sugar Smart app for free today. [online] Available at: https://www.nhs.uk/change4life-beta/campaigns/sugar-smart/sugar-facts [Accessed 15 Mar. 2016].

Obesity Knowledge and Intelligence team. (2016). Public Health England. [online] Noo.org.uk. Available at: http://www.noo.org.uk/slide_sets [Accessed 4 Mar. 2016].

Prentice, A. and Jebb, S. (1995). Obesity in Britain: gluttony or sloth?. BMJ, 311(7002), pp.437-439.

Public Health England. (2015). [pdf]. Sugar Reduction: The evidence for action. Available at: https://www.gov.uk/government/publications/sugar-reduction-from-evidence-into-action [Accessed 15 Mar. 2016].

Scarborough, P., Bhatnagar, P., Wickramasinghe, K., Allender, S., Foster, C. and Rayner, M. (2011). The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006-07 NHS costs. Journal of Public Health, 33(4), pp.527-535.

Sugar Reduction: The evidence for action Annexe 3: A mixed method review of behaviour changes resulting from marketing strategies targeted at high sugar food and non-alcoholic drink. (2015). 1st ed. England: Public Health England, pp.pg 7-8.


Stockman, J. (2006). Preventing Childhood Obesity by Reducing Consumption of Carbonated Drinks: Cluster Randomised Controlled Trial. Yearbook of Pediatrics, 2006, pp.407-408.

Syrad, H., Falconer, C., Cooke, L., Saxena, S., Kessel, A., Viner, R., Kinra, S., Wardle, J. and Croker, H. (2014). ‘Health and happiness is more important than weight’: a qualitative investigation of the views of parents receiving written feedback on their child’s weight as part of the National Child Measurement Programme. Journal of Human Nutrition and Dietetics, 28(1), pp.47-55.

Nutrition Basics


Nutrition

Nutrition consists of the functional components in food that an organism must obtain in order for it to grow and flourish. Nutrition simply put is a collective term for all of the nutrients required by an organism to sustain life and promote health.

“Nutrition is the intake of food, considered in relation to the body’s dietary needs. Good nutrition – an adequate, well balanced diet combined with regular physical activity – is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.” – (World Health Organisation)

Nutrients
Nutrients are the organic and inorganic substances found in plant and animals material deemed biologically functional to an organism’s physiological demands. Simply put, nutrients support the functioning of an organism on a cellular level. There are two types of nutrients; Essential nutrients, of which the body cannot biosynthesize (or can but in inadequate amounts) which must be obtained from diet and non-essential nutrients, of which the body can biosynthesize in sufficient quantity.

“Food provides a range of different nutrients. Some nutrients provide energy, while others are essential for growth and maintenance of the body. Carbohydrate, protein and fat are macronutrients that we need to eat in relatively large amounts in the diet as they provide our bodies with energy and also the building blocks for growth and maintenance of a healthy body. Vitamins and minerals are micronutrients which are only needed in small amounts, but are essential to keep us healthy. There are also some food components that are not strictly ‘nutrients’ but are important for health, such as water and fibre.” – (British Nutrition Foundation)

Macro/micro-nutrients
There are six main essential nutrients carbohydrates, fats, protein (the macronutrients), vitamins, minerals (the micronutrients) and water which is also considered an essential nutrient.

Macro-nutrients are generally obtained from the diet in amounts ranging anything from tens of grams to hundreds of grams. For example the protein requirements are based on the “RNI” (Reference Nutrient Intake) and for an average UK adult is 0.75g per kg of body weight, which is 53g for a 70kg adult. Compare this to carbohydrate requirements, based on “DRV’s” (Dietary Reference Values), which are 50% of total energy intake which would be 313g on a 2500 kcal diet.

Micronutrients however, are required in far smaller amounts and are measured in milligrams and micrograms. Intakes are based on the RNI’s and are based. The dietary recommendations for intakes of B12 for example are so small the amount needed would fit on the tip of a pin since only 1.5 micrograms is required.

Non-essential nutrients are nutrients which do not need to be directly obtained via the diet since they are indirectly obtained via substrates and can be synthesised endogenously (within the body). Non-essential nutrients mainly consist of the non-essential amino acids, but also nutrients such as inositol (vitamin B8) and certain minerals are also considered non-essential, although this does not undermine the importance of these nutrients for our health.

Phytochemicals
There are of course very important components of foods that do not get official recognition as “essential nutrients” although their exclusion from this category might mislead one to think they’re not as important. They are, and arguably more so when the aim is to optimise health. Phytochemicals are beneficial non-nutritive components of foods such as vegetables, fruits, whole grains, herbs, nuts and seeds. These plant chemicals include phenols, terpenoids, sulfurs compound, pigments and other antioxidants, all of which have shown to promote significant health benefits and may have specific preventative implications for certain disease including cancer and cardiovascular disease.  

Is diet enough to obtain all the nutrition we need?
Absolutely. Most people should be able to get all the nutrients they need by eating a healthy, varied diet, including multiple colours and fruit and vegetables. However, there are a few exceptions where supplementation may be wise or even necessary. For example, if a woman is planning to conceive a child it is recommended they take a folic acid (vitamin B9) supplement to prevent congenital birth defects. Unless of course you can consistently consume at least 300 mcg of dietary folate, supplementation is a sensible option. Spina-bifida can occur in Mothers whose B9 intake is insufficient before conception and particularly during the first 12 weeks of pregnancy. Vitamin D is another vitamin in which it is difficult to obtain in sufficient amounts all year round from food and sunlight alone. This is even more the case for vulnerable groups such as pregnant women, the elderly, Muslims who veil the skin, those with dark pigmented skin such as Asians and Africans, children and also Caucasians with fair skin. Current research now supports the idea that most people would benefit from vitamin D supplementation as current intakes and levels of UVB exposure are inadequate, especially for building reserves for winter. Moderate to high dose supplementation may also be a necessary requirement for those or are clinically deficient as to consistently raise serum levels from deficiency status into adequate ranges, which even then could take months.

 

Bibliography

Barros, L. and Ferreira, I. (2017). Editorial: Phytochemicals and their Effects on Human Health. Current Pharmaceutical Design, 23(19).

Holick, M., Binkley, N., Bischoff-Ferrari, H., Gordon, C., Hanley, D., Heaney, R., Murad, M. and Weaver, C. (2011). Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 96(7), pp.1911-1930.

Nutrition.org.uk. (n.d.). What are nutrients? – British Nutrition Foundation. [online] Available at: https://www.nutrition.org.uk/healthyliving/basics/what-are-nutrients.html [Accessed 20 May 2016].

R, J, BERRY et al. (1999) PREVENTION OF NEURAL-TUBE DEFECTS WITH FOLIC ACID IN CHINA. The new England journal of medicine. [Online] Available from: http://folictrial.org/wp-content/uploads/2009/09/Prevention-of-neural-tube-defects-with-folic-acid-in-China.pdf [Accessed on 7.2.15]

Who.int. (n.d.). WHO | Nutrition. [online] Available at: http://www.who.int/topics/nutrition/en/ [Accessed 20 May 2016].

Vital Nutrition

Nutrition is vital to us, plain and simple, we need it, we enjoy it and we can’t live without it, but nutrition is a word that’s been ignored. Nutrition is something that’s so overlooked and so disregarded by too many people with the same goals. It still surprises me to see so many people are so unaware of just how important nutrition is to many things including their mood, their performance, their results in the gym and most importantly their vitality and health.

It may surprise you to know many physical and mental health conditions today can be attributed to a poor diet. Nutrition during pregnancy is a crucial period as even mild deficiencies can have profound long term implications or worse cause permanent birth defects. Child and adolescent nutrition is also of the up-most importance for the healthy development of a brain and body. Good nutrition at these stages can be pivotal. The correct nutrients and minerals boost the brains cognitive abilities helping with memory retention, concentration and learning ability. These nutrients also play key roles as structural components of all growing tissues all throughout the body. Nutrition is vital not just for aesthetic purposes but for the very foundations of our growing bodies since before we are even born.

Diet is the key to long term results

Most people however are fairly familiar with nutrition in terms of body composition and are aware of the ups and downs of dieting and trying to lose weight. So many times I have had people ask me the same questions over and over, they ask why they’re not losing weight or tell me how they cant seem to put muscle weight on and ask why that is. I usually respond with the same question first… well, tell me what you eat?

Nutrition provides our body with sustenance, it provides us with the vital vitamins, minerals and nutrients our body thrives off to make almost every physiological process possible and if your exercising this demand for sustenance is increased. Third to oxygen and water its an important life source we can’t live without. The body needs food and if it has no source of energy it will catabolise it’s own energy rich tissues in order to get what it needs. The body seeks these nutrients for it’s immediate needs at any cost.

This one reason many people fail on their fitness goals. They use fad diets that are far too restrictive which deprive the body of many essential nutrients or eat too much of certain nutrients altogether. Without some basic understanding of these processes, the long term result can be one step forward one back at best and at worst unhealthy. Of course this all leads to a very dismayed and disheartened individual that thinks they are “just one those people that cant lose/gain weight” despite trying every so-called diet when in fact the reasons why they’re not losing weight are very simple. They just don’t know it yet.

Today’s nutrition tradition

Unfortunately in today’s society nutrition has become more then just a means to survive, gone are the days where food was purely a source of fuel and a way to survive. We now live in an age where food is used traditionally as a way of socializing and a way of having fun. It’s also used as an emotional tool to make us “feel better” when were down and for a large majority its even used purely just to pass time. Due to the fact we no longer have to hunt for our food (and its available in abundance in mostly unnatural and processed forms all within a stone throw away), we now suffer with more medical issues associated with food alone more than ever. Diabetes, obesity, fatty liver disease, coronary heart disease, hypertension, hyper-lipidemia to name a few. Cancer, cardio-vascular disease, stroke, lung and liver disease are Britain’s biggest killers, most of which are preventable or attributed to poor diet and/or lifestyle. We also now live in an age where obesity has more then doubled since 1980, its dominating people of all ages and is also growing concern among children. Nutrition is an absolutely crucial element in improving longevity and good health. This is why it is in my view that food should be eaten mostly to provide the body with a benefit first and pleasure or convenience secondary where possible. We are after all what we eat what we eat.

Good nutrition alongside a healthy lifestyle

Good nutrition also should not excuse hard work in the gym. Research has consistently shown diet alone is less effective than diet and exercise combined. Training and nutrition go hand in hand, there’s no doubt about that and one will only take you so far. Once you have a healthy structured eating habit which reflects your goals, a good training regime will then be like the icing on the cake, that last piece to the puzzle…And remember, power is knowledge but knowledge is nothing without application.

Wrong to teach kids about nutrition?

Parents, kids and food education
This article was inspired by an unfortunate disagreement that had arisen between me and someone I know. This disagreement was sadly over my efforts to encourage healthy eating in my Daughter (who was a very aware and conscious 5 year old at the time) and from the education I had provided her regarding the benefits and the potential dangers of unhealthy food. My efforts with my daughter and with many other people whose lives and healths I have helped improve over the years, have never been based on exaggerations, or scare tactics. My efforts, identical to my articles, views, values and philosophies in nutrition, have always been influenced and supported by scientifically validated facts and evidence as well as logical rationale.

This is an important point to note. I don’t believe in lying to my child in the same way I don’t expect my child to lie to me. In fact I have a real hard time with the whole Santa thing and just avoid the question when she asks me. I don’t believe in discouraging them from eating crisps by telling them, “if you eat crisps you’ll get cancer”. I don’t agree with scaring them into eating healthy food. In contrast I disagree with saying things like “if you eat your vegetables you can have dessert” as I also don’t agree with bribing them to eat healthy food with the reward of eating unhealthy food afterwards either. In fact it completely contradicts my point of promoting healthy food over unhealthy food. I don’t agree with distorting the truth in any way or promoting unhealthy eating habits to promote healthy eating to kids, at all.

Sometimes the best way to teach a child, is to teach a child. Sometimes a child needs to learn and know instead of being told what to do or what not to do. If you can educate a child on why they should be eating healthy food, why they should only eat chocolate sparingly, then that’s half the battle. Once a child is aware of the effect on health food can have, based solely on facts, it’s human nature and instinct to avoid or at least reduce contact with things that we know could be harmful to us through behavioural change. This works particularly well in children, more so than in adults because children function through more primal instincts and emotions. Where as with maturity, comes the complex advancement in attitudes, willful ignorance, pride and stubborn behaviours which can of course have a negative effect on one’s on health.

Ignorance is far more common in adults especially with regards to health. Ignorant not just about nutrition, but willfully ignorant to acknowledge anything that may challenge their current paradigm, regardless of logic or fact. But that’s a discussion for another article. Children’s instincts and emotions are far simpler. They are more instinctive in nature in the respect that they show less ignorance to dangers in general. This instinctive nature can guide children in making healthier food choices. Based on this they can potentially show much more enthusiasm in being healthy, particularly when they understand and are aware of the negative effects such things can have on their health. In the same way a child can learn to associate strangers or say a wasp with negative connotations you can also create a negative association with unhealthy food.

This brings me swiftly to my point. This is how I have educated my daughter. I’ve made her aware of facts and educated her on how to be healthy. She can tell the difference between refined and wholegrain carbohydrates, with a fairly good understanding of which ones can lead to sharp rise and falls in blood sugar and which ones don’t. Some kids her age are still learning the alphabet or their months, but my Daughter has been able to distinguish all the major muscles on the body from gastronemus to trapezius with near perfect pronunciation from the age of 4. What’s great is that she generally enjoys learning about food and is always quizzing me for information and then randomly recites information back to me two weeks later, much to my surprise and satisfaction. I would say she is the epitome and vision of what many public health professionals including myself want for the future of children in this country.

 It’s now becoming more common for children to get diagnosed with adult onset type II diabetes despite the fact its usually diagnosed in adults over the age of 40, children that are now on medication because of an adopted, family drawn perception that has been perpetuated by clever food marketing in the media, that certain refined and processed foods are normal foods to eat and are part of our staple diet. But yet my daughter knows what diabetes is. Not only does she know what it is she’s aware of what foods are potential promoters of it and she limits her intake of them foods. Given that there are more children now obese and overweight with diet related diseases than ever before, the importance of this can’t be down-played or shrugged off.

Chocolate is NOT food. Crisps are NOT food. Refined, processed, chemically altered, artificially made, aggressively manufactured, contaminated man made junk is NOT food. If it does not grow from natural vegetation teach your child to limit their intake of it and educate them about why.

So what age is the right age to tell a child fruit offers many nutrients that help you learn better at school? when is the right time to tell a child a diet high in sugar will decay their teeth and can lead to health problems? when is the right time to tell them that having crisps for lunch will only provide empty calories that will not give them lots of long lasting energy to play with their friends at break? when is the right time to tell a child the saturated fat in McDonald’s burgers is not good for their heart and to be weary of marketing ploys designed to appeal to a child’s immediate desires? The main point of being a parent is to look after and protect your child. It’s to provide them with the best quality of life possible. Then surely wouldn’t the right answer to the question; when is the right time to teach kids about health? be at the very least, sooner, rather than later?

I may be criticised for teaching my daughter things she “doesn’t need to know about at her age” but at least I know with confidence my Daughter is not part of the huge public health crisis where many of today’s kids will grow up unhealthy, over weight, nutrient deficient and lacking fundamental food education to protect them from diet related diseases in the future. Now that for me, is a comforting thought and well worth the criticism.

“Good” carbs vs “Bad” carbs

 

Introduction

For many people and particularly dieters, carbohydrates have had a sinister stigma attached to them for many years now. Their reputation has evolved from the understanding that they are a significant contributing factor in the cause of weight gain, as well as their association with promoting disease conditions. Because of this it has led to many misconceptions and fear of consuming Carbohydrates. In this article the differences between the generic terms of “good” carbs and “bad” carbs will be discussed using complex carbohydrates and simple sugars as prime examples will be discussed. In particular the physical states and physiological responses to both types will be discussed outlining key points for health and improving body composition.

Key factors when it comes to carbohydrates

  • choose low G.I carbohydrates
  • choose the ones highest in fibre
  • look for the ones rich in minerals, vitamins and if possible protein
  • go for natural and whole not refined and processed
  • refrain from over cooking and over boiling them
  • add protein or fat to your carbohydrates to lower its G.I rating

The dark side of carbohydrates

The reality is that in today’s society, lifestyle and dietary related diseases are on the rise with diabetes being the leading threat to human health along with heart disease. Right now more than 3.7 million UK people are suffering with type II diabetes. The ironic thing about this fact is that type II diabetes is a completely self inflicted condition caused by bad dietary habits, specifically from the excess consumption of refined carbohydrates. The sad thing about this is that type II diabetes is completely reversible if tackled early enough and yet unfortunately it is on the rise and is estimated to hit 5 million people by 2025 [1]. Our current high refined carb diet may have been encouraged by much earlier warnings about the increasing rate of ischemic heart disease caused by the high consumption of saturated fats at the time. The warnings encouraged a decrease in the intake of fats in favour for eating more complex carbohydrates [2]. This has resulted in mass confusion as many people today still believe the complex and simple carbohydrates term is an effective way to distinguish between “good” and “bad” carbohydrates. Unfortunately the truth is, excuse the pun, less simple and more complex then that.

Good or bad carbohydrate?

As I will explain in another article there is no good or bad carbohydrate per se, there can be a time and a place for both particularly for those participating in sports. But there are some key differences and reasons as to why one type is generally considered to be “bad” and one is considered to be “good” and I’d like to address the differences between the two.

Simple sugars, as the name implies, have simple chemical structures made of monosaccharides (single sugar units). Simple sugars like glucose for example are said to be “bad” as they are absorbed through the intestinal tract quickly promoting a hormonal response (releasing insulin) that causes weight gain, fatigue and sugar cravings. Complex carbohydrates due to their complex chemical structure as the name implies, is made up of a complex chain of disaccharides and polysaccharides, (two or more sugar units combined). Complex carbohydrates like the sugar lactose for example is a disaccharide its made of two sugar units glucose and galactose and is said to be “good” as they are absorbed and digested slowly. Very little insulin is released from complex carbs and the conventional understanding goes that complex carbs provide a slower release of energy from the food and they help improve fat burning. But why is insulin bad and how does it cause weight gain? Well this depends entirely on ones insulin sensitivity.

If your muscle cells are insulin sensitive at the time of consuming simple carbs the muscles are primed to absorb the glucose and convert it into its stored form, glycogen. If your not insulin sensitive when consuming simple carbs the path way for glucose storage in skeletal tissue is closed and the flood gate is open to fat cells. This is how and why people get fat from simple carbs like sugary sweets and this is why its best to consume complex carbs at times when insulin sensitivity is low.

The answer to the next question, how do you know whether your muscles are insulin sensitive or not, depends on many factors. Your insulin sensitivity will be higher if you are in an active state, a fasted state or if your glycogen levels are depleted. For example first thing in the morning and after an intense workout your insulin sensitivity will be higher so consuming simple carbs will actually help with recovery and will refill depleted muscle energy. On the contrary if you eat the same type of simple carbs late at night in an inactive and rested state, insulin sensitivity will be low which as mentioned will promote fat storage. Consistently high insulin levels (on top of causing weight gain, fatigue and sugar cravings) can eventually lead to insulin resistance and type II diabetes. So in conclusion the conventional understanding goes simple = fast digesting and complex = slow digesting. However relying solely on this simple and complex classification is not wholly accurate and can often be confusing and misleading and here’s why…

Simple doesn’t always mean fast digesting, complex doesnt always mean slow digesting

Fruits are considered sources of simple sugars and yet some types of fruit despite their simple chemical structure release their glucose slowly into the blood stream which keeps insulin levels low. This contradicts the simple = fast digesting mantra. Conversely waxy maize starch is a complex carbohydrate yet it digests so fat its comparable to glucose. Insulin and glucagon compete with each other, insulin is a storage hormone, glucagon breaks down energy stores, when you have high levels of circulating insulin your body is in storing mode and glucagon will be low therefore you are not in energy burning mode. Some fruits which are considered a simple sugar, don’t actually impact insulin dramatically because of the slow release of energy which of course equates to steadier sugar levels, reduced cravings and appetite, better mood and enhanced fat burning. This would be considered by many to be a positive hormonal response, if your health and body weight is of any concern. In fact fructose the simple sugar found in fruit despite it being simple has even shown to be useful in treating people with type II diabetes due to its slow digesting nature [3].

In contrast some types of complex carbohydrates, white rice for example, despite its complex chemical structure is broken down and absorbed quicker then some simple carbohydrates and would technically put them in the category of being a “bad” carbohydrate based on the negative hormonal response from the body. Basically because white rice considered a complex carbohydrate causes high amounts of insulin to be released which blunts glucagon production meaning no fat burning or burning any stored energy, energy spikes and crashes, sugar cravings and weight gain, all despite the fact it is complex which is considered “good”. This of course is why it causes what is considered to be a negative hormonal response.

So as you can see, it’s this inaccurate classification of carbohydrates that has led to a huge misconception about what’s healthy and what isn’t. This somewhere down the line has contributed to the huge increase in refined carbohydrates leading to a continuous flurry of health problems worldwide.

The glycemic index scale

So how can we tell what’s good or not? The glycemic index is a reliable and practical way of determining a good choice of carbohydrate, it’s very basic and easy to use and understand. The glycemic index was devised for people who were diabetic and trying to manage their blood sugar levels. The G.I index is a measurement based on a percentage of how quickly 50g of a carbohydrate enters the blood stream compared to glucose which enters the bloodstream almost instantly and has a GI rating of 100. So say a baked potato has a GI rating of 85 it means the baked potato digests and releases its glucose into the bloodstream nearly as fast as glucose, only 15% slower, or in other words 0.85x the speed glucose would enter the blood stream. Since low glycemic index (low G.I) carbs are digested slow and release their energy slowly they are better for keeping sugar levels steady and healthy therefore should be the prime choice of carbohydrates for those managing diabetes and especially for those trying to avoid it [4]. High glycemic carbs on the other hand are digested quickly and therefore release their energy too quick and are not considered good choices for our health among many other things such as energy levels and appetite [5].

High GI vs Low GIexamples of low vs high GI foods

Carbohydrates that digest quickly, like white rice for example will have a high glycemic index (high G.I) that promote the release of insulin from the pancreas to regulate the high amounts of sugar rapidly entering the blood. This fast acting regulatory endocrine system is important to us because the sugar in excess will actually poison the blood. However insulin is a double edged sword since insulin is a storage hormone and is directly responsible for the deposit of glucose into adipose tissue leading to weight gain. Further more repeated and chronic insulin responses from the continuous consumption of high GI carbohydrates will lead to decreased insulin sensitivity. When this happens insulin no longer has the same effects on glucose metabolism it once had. Similar to taking a drug continuously your body eventually becomes tolerant to it, consuming refined high GI carbohydrates day in day out is the same thing but in this case you become resistant to your bodies own natural mechanism of controlling its blood sugar via the release of insulin. The end result at the very least is insulin resistance and clinical diagnosis of type II diabetes [6]. Low GI diets have long shown in studies on obese subjects that not only do they improve insulin sensitivity but they also increase fat oxidation and reduce waist circumference compared to those on high GI diets [7].

That excludes other benefits such as increased and sustained energy release, improved mood, less cravings and decreased cholesterol etc. Carbohydrates are certainly not the enemy but I would say misunderstanding them most definitely is.

What to look for

There are obviously a few components when it comes to determining what sources of carbohydrate are the best to consume but they can be summed up by a few simple differences. You should always choose more natural wholesome sources of carbohydrates that are high in soluble or insoluble fibre and are rich in nutrients like vitamins and minerals. The more wholesome and less refined a carbohydrate is generally the better. Refining of a carbohydrate really makes no sense because its a process of stripping a once wholesome and natural food that was full of fibre and nutrients down essentially to nothing but starch. The reason this is done is mainly to increase shelf life which of course benefits the companies selling it, as refined fibre reduced carbohydrates are less susceptible to go off. Cooking carbohydrates also changes its digestibility and therefore can increase its G.I rating, so a baked potato would have a higher glycemic index compared to a raw one, the same applies to food when you boil it too. In contrast adding fat and/or protein to a meal containing carbohydrates will actually lower its G.I rating. This is why consuming protein with every meal is recommended for fat loss.

Summary

  • choose low G.I carbohydrates
  • choose the ones highest in fibre
  • look for the ones rich in minerals, vitamins and if possible protein
  • go for natural and whole not refined and processed
  • refrain from over cooking and over boiling them
  • add protein or fat to your carbohydrates to lower its G.I rating

Conclusion

It’s clear from all of the evidence long term consumption of refined carbohydrates is a recipe for the decline in the future of human health. In summary as humans if we are to stay healthy, disease free and also wish to maintain a healthy weight, low G.I carbs should be the main source of carbohydrates for everyone looking to avoid insulin resistance, diabetes and especially for those who want to avoid unnecessary weight gain, feelings of fatigue and repeated sugar craving cycles. The long term consumption of high G.I carbs is a slippery slope and we must all work together to stay off for the good and the benefit of our future generations to come.

[1] http://www.diabetes.org.uk/documents/reports/nhs-health-check-lets-get-it-right-0912.pdf

[2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869506/

[3] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682989/

[4] http://www.ncbi.nlm.nih.gov/pubmed/23705645

[5] http://www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Glycaemic-Index-GI/?gclid=CjwKEAjwxtKeBRDMzoeQmYn5uHcSJACGCF3D1mPlKw9KXkfkcUMg3zlXVwRxvMUnLj6wn_C3v3Zg-RoC8Tbw_wcB

[6] http://www.ncbi.nlm.nih.gov/pubmed/19934403

[7] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937245/