Chapter 17

CONTROLLING YOUR CARBS AND LIKING IT

All carbohydrates are most definitely not created equal. The right carbohydrates in moderate amounts can help you stabilize your blood sugar and may even help prevent diabetes; the wrong carbs (particularly when consumed in excess) can send your insulin and blood sugar levels soaring out of control.

We can look at carbs in a number of different ways. The traditional nutritional division is simple and complex carbohydrates. But as we’ve said, these terms are misleading. For example, berries are classi- fied as simple carbohydrates, because fructose, the sugar in fruit, breaks down easily. Meanwhile, a high-carbohydrate granola bar full of added sugar is regarded as a complex carbohydrate because it contains whole grains, which don’t break down as quickly. In this case, the nutritional recommendation to eat more complex carbohydrates would mean eating more of some pretty unhealthy foods and less of some very healthy ones.

GOOD CARBS, BAD CARBS

As you learned about the Atkins Glycemic Ranking (AGR) in Chapter 14, the glycemic load (GL) and glycemic index (GI) are a much more helpful way to look at the carbohydrates in your diet. Now let’s take a closer look at carbohydrates to better understand why we suggest eating some carbs on a regular basis, others in moderation, and certain carbs rarely or never. Whichever carbs you eat on any given day, you must keep your Net Carb count within your personal threshold.

We have talked a lot in this book about how carbs can raise your blood sugar; but that does not mean that all carbs are bad. The ones that raise your blood sugar too quickly and too high are high-GI foods that also have a high GL. These are mainly foods that are highly re- fined, highly processed, and low in fiber: white rice, bread made with bleached white flour, pasta, French fries, grits, and so on. But we also have to be aware of unrefined carbs that have a high GI, such as wild rice and millet. While those are inherently good foods, it’s important for people with blood sugar problems to choose unrefined, high-fiber, low-GI/low-GL carbs—the ones that end up having a low AGR. Lots of unrefined, delicious carbs can be found on the AGR “Eat regularly” and “Eat in moderation” lists (see Appendix 4, page 467)—acorn squash, lentils, peanuts, and nectarines, for instance.

ADD CARBS WITH CAUTION

All carbs always count, however, and even large portions of low-AGR foods could cause an undesirable jump in your blood sugar. To moderate the impact,add small portions of low- and moderate-AGR foods back into your diet as part of a meal that also contains protein, fat, and dietary fiber. As you do so, keep an eye on your weight, blood sugar, triglycerides,symptoms,and appetite control.If weight loss stops suddenly or you regain weight, if you get jittery and hungry, or if your blood sugar or triglyceride levels go up, cut back on your servings of these carb foods. On the other hand, if these indicators remain stable, go ahead and have an occasional serving. Be extremely aware of portion size, however. The standard portion of, say, cooked acorn squash is only ½ cup. If you’re very carb-sensitive, you may have to limit even that amount to just a few times a week. For ideas on how to use small amounts of higher-carb veggies, legumes (beans), and even grains, check out the meal plans and recipes in Chapters 26 and 27.


CARB CRAVINGS: HOW TO FIGHT BACK

For some people, eating even a small portion of a high-quality carbohydrate such as brown rice is very difficult—it triggers their carbohydrate cravings. This can lead to a serious detour off the ABSCP and back onto the blood sugar roller coaster.What happens then? Rapid changes in insulin and blood sugar levels, mood swings, weight gain, gas and bloat- ing,preoccupation with food—in short,eating those carbs could trigger your addiction (let’s call a spade a spade) and cancel out all the health gains you have made.

When carbohydrates beckon,fight back with some simple strategies:

Once the craving is past, understanding what set it off can help you avoid it next time.Did you go too long without eating,triggering a drop in blood sugar? Try not to go more than four waking hours without a meal or a protein snack—a slice of turkey, a chicken drumstick, or a small piece of cheese,for instance.Did you eat because of stress or anxiety, not hunger? Simply being aware of why you’re eating can help here. And if you find yourself eating because you’re stressed, again, choose a high-protein food to snack on—this helps stop stress-related cravings. Did you let someone pressure you into eating? You’ve probably heard this all too often:“Go ahead,a little bit won’t hurt you.”You know a little bit can hurt you, so simply say,“I’m being more careful about what I eat these days.”


CHOOSING GRAINS WISELY

Even unprocessed whole grains are relatively high in grams of Net Carbs per serving. Some are relatively low in GI and GL, however, which is why certain whole grain foods, such as kasha (buckwheat groats) and whole wheat couscous, fall into the “eat in moderation” category on the AGR. For people who need to keep their carbs in the 20- to 40-grams-a-day range, however, eating even these foods may not be possible. If you’re still in the Ongoing Weight Loss phase of the Atkins Blood Sugar Control Program or you don’t have your blood sugar under control, you’ll have to be very cautious about adding grains back into your diet.

Old-fashioned oatmeal and barley,whole grains that are on the “eat regularly” AGR list, are both high in beta glucan, a type of digestible fiber. Beta glucan helps keep the carbohydrates in oatmeal and barley from having a big effect on your blood sugar, and it also helps slow down your absorption of carbs from other foods as well.1 Once you can handle whole grains,a bit of barley is a great addition to soups and casseroles, and oatmeal—the original comfort food—makes a warm and filling breakfast food or snack. The value of oatmeal comes only from whole oats, however. Look for “steel-cut,” “old-fashioned,” or “rolled” oats and enjoy their chewy texture and nutty flavor. The processes involved in making quick-oatmeal and instant-oatmeal products remove a lot of the fiber and beta glucan, which means the carbs enter your bloodstream too quickly. Instant oatmeals also usually have sweeteners and other high-carb additions.

GRAINS FOR BREAKFAST

Many ready-to-eat breakfast cereals claim to be healthful, but a quick check of the ingredients label reveals that they are made mostly from refined grains and added sugars; many also contain trans fats. Corn- flakes have a higher GI than a slice of white bread!2 If your daily carb allowance is above 60 grams of Net Carbs, you might be able to have a good whole grain choice for breakfast now and then. But check the ingredients label, and remember to combine protein and fat with the grains, and watch your blood sugar and symptoms afterward. Good options include Fiber 1, old-fashioned oatmeal, and unsweetened müesli (a mixture of oatmeal, wheat germ, other grains, and nuts). As an alternative you could try one of the low-carb breakfast cereals that use soy instead of grains. What to pour on that cereal? There are several options other than milk,which contains the sugar lactose,making it high in carbs (and many people have trouble digesting it). You can add cream by itself or diluted with water, or use low-carb soymilk or a reduced-carb dairy beverage.


FOOD INTOLERANCES

It’s surprisingly common for people to have an intolerance for grains and yeast, which is used in bread and other grain products as well as in fermented foods such as yogurt. Symptoms may include diarrhea, heartburn, gas and bloating, headaches, chronic tiredness—and unstable insulin/blood sugar. Paradoxically, food intolerances can provoke cravings for the very food that causes the symptoms. In the case of wheat sensitivity (one of the most common),it means frequent cravings for high-carb foods like bread,bagels,and pasta,which aggravate unstable blood sugar.Food intolerances,also known as food sensitivities,can be isolated by keeping a food diary, which will allow you to associate symptoms with eating a particular food. A trial period in which you eliminate the offending food from your diet can help you confirm an intolerance or sensitivity.

If you notice that certain symptoms improve when you’re on Induction—during which you consume almost none of the common offenders—and recur at higher levels of carbohydrate intake, consider eliminating any recently introduced food,which may well be the culprit. After a symptom-free period, it might be possible occasionally to add small amounts of offending foods without symptoms returning.


BEANS AND BLOOD SUGAR

Beans, peas, and lentils—also known as legumes—in all their many colors and flavors,are another delicious source of low-GI/low-GL carbohydrates. (Technically speaking, peanuts are legumes, too, but for all practical purposes they’re treated as nuts.) Like whole grains,beans are rich in digestible and nondigestible fiber, vitamins, minerals, and other nutrients.

On the plus side, beans are very low on the GI ranking, and their high fiber content means they also have a very low GL. In the AGR, some beans, including bean products such as tofu (bean curd) and unsweetened soymilk, fall into the “eat regularly” category. A few that are slightly higher on the GI/GL rankings, including roasted soybeans, chickpeas,and kidney beans,fall into the “eat in moderation”category. The beans to avoid are baked beans and similar dishes—but not because of the beans. Baked beans, barbecued beans, and similar dishes contain molasses and other added sugars that add a lot of empty carbs, which can put you back on the insulin/blood sugar roller coaster.

On the negative side, beans are relatively high in Net Carbs, meaning you need to keep your portions to a ½ cup or so—and only if your daily carb threshold allows it.Your best bet is to find ways to use beans in small portions. For instance, add some chickpeas to a tossed salad, lentils to a beef-vegetable soup, or cooked black beans to a pork and veggie stir-fry.

THE GRAINSAND MORETO AVOID

Review the AGR list for grains on pages 471–472.A lot of these grains, including brown rice and brown-rice cakes, are in the “eat sparingly” category. On the AGR list for vegetables on pages 468–469, you’ll also see that sweet corn and white potatoes in any form (French fried, baked, mashed) are in the “eat sparingly” column. All these foods are very high in carbohydrates and relatively low in nutrients; their GI rankings are very high, and so are their GL rankings. Even once you have reached your weight goal and normalized your blood sugar, we advise that you still treat these foods as very rare treats—in the same category as birthday cake. They can never again become a regular part of your diet without your suffering immediate consequences. Nearly eliminating these foods from your diet may take some getting used to, but as you continue to feel the improvements in your health the ABSCP brings, you’ll find there’s little room on your plate for low- quality carbs.


STARCH-BLOCKING BEANS

An extract made from white kidney beans is now widely sold as an over- the-counter “starch blocker.”These heavily advertised products claim to “neutralize” the starch in high-carb foods. All you have to do, the ads claim,is take a couple of these pills at the start of a meal,and they’ll block your absorption of about 75 percent of the calories you eat from carbohydrates. Starch-blocking products do contain a substance found naturally in white kidney beans (as well as some other beans and also wheat) that inhibits or blocks amylase, the enzyme your body uses to break down carbohydrates in your intestinal tract. In fact, the starch-blocker supplements work in a similar way to the prescription drug acarbose (Precose or Glyset).

Both the supplements and the prescription drugs have serious drawbacks. They’re not meant to aid weight loss—they’re designed to help control blood sugar—but that doesn’t stop unscrupulous manufacturers from pushing the supplements as a way to lose weight while eating all you want of anything you want. No studies of acarbose have shown that the drug causes weight loss,although a few studies have shown that some people with impaired glucose tolerance are less likely to become diabetic if they take the drug.3, 4 The side effects of blocking carbohydrate digestion can be very unpleasant.Severe cramps,diarrhea,and gas are likely. Many people using acarbose experience flatulence. Dr.Atkins never prescribed acarbose.Why take a costly drug with nasty side effects when you can benefit your health considerably more by controlling the carbs in your diet to begin with?




WHAT’S YOUR CARB IQ?

1. Which beans are preferable?

  1. lentils or black-eyed peas
  2. chickpeas or pinto beans
  3. baked beans or kidney beans

2. Which grains should you choose?

  1. white rice or barley
  2. old-fashioned oatmeal or instant oatmeal
  3. brown rice or buckwheat groats (kasha)

3. Which fruits should you choose?

  1. mango or apple
  2. raspberries or banana
  3. strawberries or grapes
  4. kiwifruit or blueberries

Answers a,1. strawber-c,raspberries;b,apple;a,3.buckwheat groats.c,oatmeal; old-fashioned b,barley;a,2.kidney beans.c,chickpeas;b,lentils;

d,blueberries.ries;