Carbohydrates: Half Truths and Whole Lies - Episode 64

Carb is not just another dirty four letter word. Carbohydrates have gotten a mixed review over the years, even cast out as a "bad macronutrient". But let's face the science, shall we? In this episode, I share my personal experience with and professional opinion on the best practices for using this powerhouse energy source, who is best suited for a low carb diet, and even how they play a role in hormone balance and insulin resistance.

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Jade:    [01:17] Welcome to the show, everybody. Today’s topic is going to be a tough one because there is a lot, a lot of information, and I’m not sure if I’m going to be able to get through all of it. I’m not even quite sure which direction this is going to go in just because there is a lot of things that we need to discuss, and this is the topic of carbohydrates. So, this may be 1 or 2 podcasts. I’ll try to fit this in as fast as I can, but I may actually do a follow up to this. So, let’s get into it really quickly. This is the topic that everyone wonders about. This is a much maligned area of health and fitness. Everyone talks about carbohydrates and right now, over the last, I would say, 15 years or so, carbohydrates are the bad guy. From my perspective, they are actually my favorite macronutrient because there’s so much that you can do with them and they’re so versatile. Let’s get a couple of things out of the way first. I think I’ll just kind of start with this idea of low carbohydrate vs. low calorie. Obviously, there has been this whole idea that carbohydrate counting is more important than calorie counting, and some of who have been following my work from the beginning, back in 2010 I wrote a book, a best-selling book, called the Metabolic Effect Diet, with my brother Dr. Keoni Teta. And we were a little bit more in the camp at that time of carb counting and insulin vs. calories, and now we’ve kind of come back to the middle. One of the reasons we have come back to the middle is because we’ve seen, in my opinion, plenty of research showing that low carb diets don’t really have any advantage over the long run vs. just counting calories in general.

            [03:09] Now, there’s a lot of people who will debate that, get angry about that or whatever. I’m agnostic in this. I’m kind of like it doesn’t really matter to me, and one of the reasons that I see this being an issue – and what I mean by when I say it really doesn’t matter to is me that I’m not one of these people who, whereas maybe in my younger years I used to be a little bit more biased and wanted to champion my cause, now I’m just more agnostic, meaning I don’t know. Like, let’s wait and let’s let the information guide us rather than taking positions that may not be viable over the long run. So, what I’ve been doing is just letting the research refine my knowledge, and right now, I’m sort of in this position where, to me, based on the research and the totality of watching it over the years, I see calories and hormones as equal things here. Because usually when we’re talking about counting carbs, we’re really talking about managing insulin. That’s the big issue there when we’re talking about fat loss. Of course, there’s a lot more about carbohydrates than just fat loss. But, one of the things you have to understand that’s partly confusing in this is that a low calorie is, by nature, by it’s very nature, a lower carbohydrate diet than what you were eating before. For example, if you are usually, almost always – let’s just make the math easy – if you’re eating a 2,000 calorie diet and you have a 40/30/30 macronutrient ratio of carbohydrates, proteins, and fats, and then you cut down that 2,000 calorie diet to 1,500 calories, and you still have a 40/30/30 macronutrient ratio. then you have decreased your carbohydrates by the very definition. What happens a lot of time in this debate is that people forget that a lower calorie diet, when you reduce carbs – or when you reduce calories, rather – and you keep the macronutrient ratios the same, that is actually a low carb diet, and even when you’re not aware. Typically, when you lower calories in general, you’re going to lower all calories from all macronutrients and you’re going to end up with lower carbohydrates. By the same token, if you lower carbohydrates, you should also be lowering calories as well. In a sense, a low carb diet is a lower calorie diet, and low calorie diet is a lower carb diet. Certainly, there are some variations here. You certainly can decrease carbohydrates and as a result of decreasing carbohydrates, dramatically increase fat intake and end up with a higher calorie diet as a result. That certainly can happen, but there is some sort of debate here of like, hey, if you’re lowering your calories and everything else remains the same, you lowering your carbs, and vice versa; so, that’s part of the issue here. Now, why do carbohydrates get this bad rap? Well, part of it is this recognition of the idea – this goes back a long time, but it’s one of the things me and my brother were talking about in our first book – is the idea that carbohydrates, especially simple carbohydrates, but carbohydrates – and we’ll talk about different ways to look at carbohydrates in a minute – are the number one macronutrient that elicits an insulin response, and insulin is a hormone that we know is involved with slowing fat release and slowing fat oxidation.

            [06:30] Remember those two things aren’t exactly the same; so, lipolysis, the breakdown of fat and release of fat from a fat cell is not the same as fat burning. So, insulin both slows lipolysis AND slows fat burning. However, insulin can’t overcome – and this is where some of the issues is – this is where chasing mechanisms, I call it, where you find out that mechanism, you say, well ok, yes, that’s true if you have calorie excess, perhaps; but what if you don’t? What if you have low calorie? What if you’re in a calorie deficit? Well, insulin can’t make you fat if you’re in a calorie deficit. There’s sort of this issue here. Now, obviously, if you have a lot of insulin and you’re in a calorie deficit, maybe there’s an argument to be made that you’re burning less fat than you normally would. And if you’re in calorie excess and you have lots of insulin, there could be an argument to be made that you’re storing more fat than you might as well because of the action of insulin. But insulin is also a hunger hormone, so we need some of it because it shuts down hunger; without it, we tend to be very hungry. And insulin is also a muscle building anabolic hormone, so without it, we can’t really put on lean mass. This 1:1 sort of short-sided mechanism of carbs = insulin = fat storage is far more nuanced than that, and hopefully you’re at your level of education where you’re beyond this; however, I will say that many popular bloggers, authors, not many people who are serious researchers believe that there’s a 1:1 ratio that insulin is the cause of obesity. And most of the research that’s looked at this has either not shown that to be the case or shown that calories are more important, just so you are aware, but you will hear the opposite all of the time out in the blogosphere, the social media world, and things like that. So, that’s partly why they get such a bad rap. By the way, I’ll say here as well that protein is also very insulinogenic, and in certain people, and in certain types of proteins, specially proteins rich in the branched-chain amino acids – leucine, isoleucine, valine – those things can very much trigger insulin, sometimes to a degree larger than what would be expected with carbohydrate intake. So, carbohydrate is not the only thing that stimulates insulin. Certainly, we know when we substitute protein calorie for calorie, when we take protein and put it in place of carbohydrates or fat, people tend to lose weight because it controls hunger and lowers calories despite the fact that it has an insulin generating effect.

            [09:02] This is part of what is going on here, Now, a couple other things that you need to look at that I still think have not necessarily been resolved, is this idea that we store very little carbohydrates in our body. The liver – our body stores carbohydrate as glycogen. You can kind of think of glycogen as animal starch, like the same thing – the kind of starch you have in a potato. Well, we have starch too; we just call it glycogen when it’s in an animal rather than in a plant. Our liver stores about 100 grams of glycogen and our muscle stores about 400 grams glycogen. If you want to get a sense of what that is, 450 grams is roughly 1 pound… or 2.2 kilograms. The thing that you kind of want to understand is that there’s a limited amount that we can store, obviously; there’s a limited amount we can store. Part of the other thing you want think about too is that glycogen and starch in general is it holds a lot of water. It’s one of the reasons why a potato is wet; it has water in it. Glycogen acts as a sponge. It’s one of the reasons why if you dehydrate a potato it gets really, really small, doesn’t it? So, one of the things you want to think about too, and this has ramifications for low carbohydrate diets, is that when you are storing lots of glycogen in your liver and muscle, you are also bringing a lot of water in with that. So, as that glycogen is depleted that water also leaves, and you can end up losing quite a bit amount of weight. Think about it this way: if we have 400 grams of glycogen in our muscle and about 100 grams in our liver, that’s basically a pound of glycogen, you know, a little bit over a pound of glycogen in our body. Now, glycogen acts like a sponge and holds 2-3 times that amount in water, so that can be 2-3 pounds lost pretty quickly over the course of 1-3 days if you completely deplete your glycogen stores in your liver and in your muscle. This is one of the reasons why – and depending on how big you are, because that’s for an average size human somewhere around 160, 170 pounds. If you’re bigger, maybe you can lose much more than that as well. This is one of the reasons why this loss in glycogen and this loss in water – this is one of the reasons why low carb diets have a faster weight loss. They tend to shed water pretty quick. It’s also a good trick, because if you’re getting ready to go to like a high school reunion, or a family reunion, or something like that, all you need to do is decrease carbohydrate intake for 3 days or so, and for most people, you’re going to use your liver glycogen and your muscle glycogen over those 48-72 hours, and you’re going to lose water with it.

[12:01] And you can lose 3 pounds, maybe 5 pounds as a result of that. Now, that is not going to be fat, it’s going to be glycogen water mostly, and maybe some fat, and maybe some water that’s not associated with glycogen. But this is partly what’s going on here. Now, there is some indication that our body – and this is not well researched and it’s kind of speculative right now what I’m going to tell you – but there is, perhaps, some indication that the body looks at its different storage forms of energy, fat vs. muscle vs. carbohydrate – and by the way, you store fat in fat tissue, you store carbohydrate in liver and muscle, you store protein on your muscle – there is some indication that the body can look at these different storage units and then begin to say, hey, we better ramp up intake of our other fuel depots. For example, there may be a 1:1 ratio – not a 1:1 ratio, but a relationship between lower glycogen levels and increased fat burning. There may be a relationship that that makes some sense there; however, there’s also a relationship between lower glycogen stores and perhaps increased hunger. So, it’s not a 1:1 relationship, is it? Because ok, you might want to decrease your glycogen stores to ramp up fat storage – or fat burning rather – but as a result of doing that you become excessively hungry and then overeat both fat and carbs. This is kind of the discussion that can kind of make your brain go a little bit crazy thinking about all the ramifications of this. Not to mention, the other thing that you need to understand is that when we deplete ANY macronutrient we also can, as a result, ramp up stress hormone production. This may be especially true as it comes to carbohydrates because the body, despite what you’re thinking, there’s a reason we have a sweet tooth, there’s a reason many people go to carbohydrates first. It’s because the body prefers to use carbohydrates. It likes it. It’s a quick energy source. You’ll often times hear people say, well, the body prefers to burn fat; some people say the body prefers to burn carbohydrate; and I just say, well, if you give your body carbohydrate and fat, what will it use typically first. It will typically use the carbohydrate first. So, you can make an argument either way, but I’m using that argument there that basically your body’s going to try to use carbohydrate. Anytime there’s excess carbohydrate it’s going to tend to want to burn that first. It’s going to tend to want to use its glycogen first, it’s going to tend to want to use the glucose in the bloodstream first before it starts dipping into your fat stores. So, there is an argument to be made that many modern eaters have their glycogen tanks, their carbohydrate tanks filled up all of the time, never depleting glycogen, never realistically getting into being able to burn fat. This has some ramifications in time restricted eating, and fasting, and keto diets, and all of that kind of stuff, which, obviously, that’s why I was saying there’s so much to cover here.

[15:08] I can go in a million different directions here. But, what you’re probably wondering, and what I wanted to try to focus on today is you’re probably saying, Jade, what about carbs? How many carbs do I eat, what types of carbs do I eat, is there timing involved, and that kind of stuff. When I typically think about carbohydrate intake, I think in an acronym. I always have an acronym, and the acronym is ACTT, A-C-T-T, and it stands for Amount, Context, Type, and Timing. So, the amount of carbohydrate, the context in which carbohydrate is eaten, the type of carbohydrate you’re eating, and timing at which you are eating carbohydrates as well. Now, I also see this ACTT acronym for carbohydrates as kind of going in a hierarchy, so I do think the amount you eat is most important right now based on where the research is. Maybe in a few years, we’ll kind of change that. But right now, I do think amount comes first in terms of the amount of calories that you’re eating and the relative percents of carbohydrate you’re eating relative to the other macronutrients; so, amount is most important I think. Context, to me, is next most important. Are you eating carbohydrates and not exercising? Are you eating carbohydrates and under stress or not under stress? Do you need it for recovery and regeneration, or to fuel performance, or are you eating a bunch of carbohydrates as a couch potato? Context matters. Type of carbohydrate, obviously, this is the thing about simple carbohydrates, fiber carbohydrates vs. non-fiber carbohydrates, that kind of thing. Even getting into things like FODMAPs, which we’ll talk about in a minute, sugar alcohols, we’ll try to cover that as well. And then timing of meals. This gets into time restricted feeding, which for those of you who have never heard of this, this is kind of related to the fasting but essentially says that most people when they wake up in the morning, they will start eating and they’ll keep eating right up until about 30 minutes to an hour before they go to bed. So, if they wake up at 8AM and they go to bed at 11PM, they’re typically eating at from 8AM to 10PM roughly. That’s what, 12, 13, 14 hours people are eating. Well, time restricted eating essentially says you need to give your body much more time to be without food, and most of this research was done in rats, where they essentially say we’ll give the rats the same amount of calories, but we’ll restrict the timing that they can eat those calories; we’ll also do things like feed them during the day vs. the night – of course, mice and rats tend to eat at night, not day; they’re opposite than us. But time restricted feeding essentially reduces the eating window and lengthens the non-eating window.

[18:04] So, obviously, reducing carbohydrates to certain timings, and not just talking about time restricted calories, but time restricted carbs is a really interesting way to kind of think about this and gets into some of the science on circadian rhythms and things like that. I want to go through this acronym, the amount, the context, the type, the time, and the ACTT acronym. First of all, let’s talk about amounts. Now, the first thing that you need to understand, in my opinion, where are currently in the science, and I think this is become more and more clear as more and more research comes out, you know, we’re essentially starting to see that calories – for a while there, we were thinking they weren’t as important as we thought – now, for me anyway, I’m like, looking at the research, it doesn’t really matter. You can take a lot of different types of diets, as long as they achieve calorie deficits, people can lose fat and become healthy on those, so amount is important here. But we’re specifically talking here about the amount of carbohydrates, so first, I just want to make clear that listen, if you are somebody who has struggled losing weight and you’ve never actually done your total daily energy expenditure, which is something that you can calculate online; you can go online and search total daily energy expenditure calculators and get a rough estimate of your calorie intakes, or your calorie need for the day based on height and weight and activity level. Then you should probably do that and make sure, then track your foods and make sure you’re not going over those calories. Then, once you do that, you start looking at amount of carbohydrate – and this will get a little bit into the context story as well. But typically, when we look at amounts of a specific macronutrient, we’re looking at them relative to other macronutrients, so we typically describe this in a macronutrient ratio of something like 30/40/30, or 40/30/30, or 5/15/80. The first number usually refers to carbohydrate percent, the second number, protein percent, and the last number, fat percent. Now, if you read a lot of research you’ll know that sometimes the protein and the carbohydrate number are switched, so you have to read carefully, because some people will say 30/40/30 means 30% carb, 40% fat – I’m sorry – 30% carb, 40% protein, and 30% fat, but other people will say that that means 30% protein, 40% carb, and 30% fat. The last number is normally the fat percent. Typically, in amounts, when I say 30/40/30, I’m talking about carbohydrate, protein, and fat, respectively. Now, I bring up 30/40/30 because, well, this is my podcast and, obviously, I’m going to give you my clinical experience.

[21:03] It doesn’t mean it’s right, but typically when I’m dealing somebody who’s just a weight loss oriented person, who doesn’t exercise a lot, and who I am not going to give an extreme diet to, what many of you who know my work I refer to as eat less-exercise less. This would be - they move, they do daily living - this would be your typical Mediterranean type of person, European type, traditional European, the sort of hunter-gatherer type approach where they’re not exercising excessively all day everyday, but they are moving a lot, and they are eating sparsely. I typically give 30/40/30 – 30% carbohydrate, 40% protein, 30% fat. The reason I do that is because carbohydrate – I usually see carbohydrate as being the high-octane jet fuel. It is the performance macronutrient. If you don’t have someone who’s doing a lot of performing, not a lot of running around and doing high intensity stuff, then you may not need as many carbohydrates; but at the same time, I still want it relatively balanced, because in my clinical experience, often times when you start to significantly deplete one of these nutrients, with the exception of protein, because people have a hard time getting protein in, which is ironically… it’s ironic because it’s the most important macro for hunger. But you don’t want to deplete any macronutrient too much for most people because it certainly can lead to compensatory eating for that same macro. We all know what this is like. You go on a low carbohydrate diet and then you start craving the very thing that you’ve been avoiding, carbohydrates, and then you go on a high carbohydrate binge. This is very much what a lot of people are doing, so 30/40/30 is a macronutrient ratio specific to carbohydrates at 30% of intake that I typically use for non-exercisers. Now, 40/30/30 – 40% carbohydrate – is something that I use for people who are more exercised oriented. Now, one thing I’ll say here is that the typical Western diet has in excess of usually 50% carbohydrates in it. Typically, the Western diet is very carbohydrate rich and fat rich, so you’re kind of thinking of a diet that’s more like 50% carbohydrate, 20, at the most, protein, and the rest fat. That’s typically what you’re talking about, or 60, or even 70% as we get up into people who are a little bit more vegan or vegetarians where they’re starting to go very high carbohydrate. As you can see, these 2 ratios for me, my non-exercising ratio 30/40/30 is one that I use for people who are relatively sedentary. My 40/30/30 is for people like myself who like to train and lift weights, and probably like most of you.

[24:02] Now, if we’re doing something like a keto-based diet or something like that, I move that down to 5/15/80 because you need a very low carbohydrate diet, and you also have to drop protein down a little bit because you want to control insulin, so typically, I don’t like having high amounts of protein, too high amounts of protein on a ketogenic diet, and very low carbohydrate. It’s mostly fat. Now, a vegan diet also is sort of like way up there, right? It’s kind of the other extreme. It’s sort of like where you’re at 70% of carbohydrate, and 15% protein, and then the rest becomes fat, so it’s pretty low fat, like 15 fat. One of the things you’ll notice right there in terms of the amounts of carbohydrates is you’ll also see this go over into types. Do you notice that the keto diet, which is 5/15/80, and the vegetarian diet, or vegan diet, which is 70/15/15 – what do you sort of notice there? What you notice is that protein is relatively low in both those diets, and in the vegan diet it’s often times more like 60, 30 on the fat side, and the rest – the rest of that tends to be protein, which is only 10%, so it’d be 60, and then 10, and then 30. You can see in these vegan and vegetarian diets, and these keto-based diets, that there’s this combination of fat and starch that’s avoided. It’s very different than the standard American diet, which has very high amounts of both starch and fat, whereas the vegetarian diets and the keto diets have one high but the other low. That is a clue for you about what we’ve started to discover when we really get down and look at diets that are health promoting and diets that aren’t. It seems like there might be something to this high combination of starch/sugar and fat. We really have 3 different diets here that I use – a higher protein diet with moderate amounts of fat and starch; or a higher fat diet with very low amounts of starch; or a higher starch diet with very low amounts of fat. One of the things we’re trying to avoid, at least it looks like, is this combination, this Western diet combination, of starch and fat. Ironically, this goes back to the conversation we were having about calories, because starch and fat have the most calories because, you know, starch/carbohydrate has 4 calories per gram. Well, so does protein. However, protein is highly satiating and more thermogenic than starch, so in a sense, it’s more easy to overeat starch.

[27:07] Now, fat, obviously, has 9 calories per gram, and it also can be overeaten. So, what happens is protein is not nearly as tasty, often times, as starch and fat, especially when it’s eaten by itself. Not many people eat just a plain grilled chicken breast or a steak by itself. Unless you are a paleo person, they often times add fat with that because it makes it taste good, or starch with that because it makes it taste good, and more average Americans add both. Essentially, you can kind of see this is part of what we’re talking about on the amounts. Now, if you are an athlete, you probably want to go up in amounts. One of the things that you might have heard buzz about is that ketogenic diets are increasing performance and things like that. There is absolutely no evidence for that except one small study that I’m aware of in endurance cyclists, and that study has not been reproduced. In fact, I think 2 other similar studies have shown that’s not the case. So, it doesn’t look like ketogenic diets are really going to give much in the way of performance for most people. By the way, those cyclists were elite cyclers too. It looks like the more exercise you have, the more you’re going to want to use carbohydrate to fuel that exercise, and recover from that exercise, but you do not want too much because it’s a bell-shaped curve there. You can have too much carbohydrate, you can basically undo some of the benefits of having low glycogen in the liver and muscle and some of that increased fat burning that may happen. That’s the amount piece. A little bit more when you’re exercising. By the way, I always talk about this idea of keeping your SHMEC in check – sleep, hunger, mood, energy, and cravings. SHMEC. It’s an acronym for those of you who haven’t heard it before. SHMEC – sleep, hunger, mood, energy, and cravings – tends to go out of check whenever you have very low levels of certain macronutrients. The only sort of thing that may – that sort of goes against that – is a keto diet, after 3-4 days or so of being on a keto diet if you can make it that far. Many people can’t because their SHMEC is so out of check, but after 3-4 days of being on a keto diet, those ketones act a lot like protein in their ability to satiate you. So, a keto diet may be an example that goes counter to that, but it does take some time to get into that. You want to be a little bit careful, and the reason I bring up SHMEC is because with carbohydrates it’s really about what I call the carbohydrate tipping point. You want enough to keep SHMC in check, enough to keep exercise performance and exercise recovery going, enough to feel good and not feel deprived, but not so much that SHMEC goes out of check, or you can’t recover, or you end up storing fat.

[30:01] That’s the amount piece. Now, the context piece we talked about already, but here’s what you need to know about this. The body, when it is under stress, it will release adrenaline, noradrenaline, cortisol, all these stress hormones. The very thing that they are doing is essentially reaching into the liver and saying give me high-octane jet fuel right now. The whole point of those things is mainly to release blood sugar. This is one of the reasons why if you have a continuous glucose monitor, or if you’ve ever tracked your blood sugars first thing in the morning when you haven’t eaten, or right after a workout, or during a workout, or during a sauna or something like that, you’ll see blood sugars rise almost to the levels that they might rise when you eat a meal. The reason that they do is because of these stress hormones. Now, here’s the issue about this. Most people focus on insulin. Carbohydrates = insulin = body fat. One of the things that they don’t always realize that there’s another mechanism that works against that. Cortisol, high levels of the hormone cortisol make the body insulin resistant as well. How will you get very high levels of cortisol? Well, any kind of stress, including low carbohydrates. This is one the reasons why some people go on lower carbohydrate diets, crave those things like crazy, but don’t end up losing the weight they want, and also because cortisol has potential relationship with belly fat, won’t lose the belly the way they should. Low carbohydrates that are too low in people who are susceptible to this stress reaction from low carbohydrates may not be a good thing. What you want to be looking at is you want to be having, again, enough carbohydrates, but not too much, and also realizing the context of this. If you’re under stress at work, if you are sleep deprived, if you’re dealing with lots and lots of exercise and things like that, then you want to be a little bit more careful and think about how this works. Having a little carbohydrate is preempting the body. It’s essentially saying, hey body, don’t overreact with stress hormones, I’ll give you some of the sugar that you want; versus this idea being like let the body just stress itself out and release that sugar. Now, it’s important to understand this because clinically I will tell you many, many people get themselves in this sort of dog chasing its own tail situation with carbohydrates. They go very low, they get too stressed out, cortisol is released, cortisol decreases the motivation centers in the brain, upregulates the reward centers in the brain, is associated with hunger and increased cravings for highly powerful hedonistic foods, and then go out and seek the same foods that they were avoiding and overconsume. If you’ve ever been someone who has done a cheat meal and it’s turned into a cheat week or a cheat month, you’re getting a sense of what this is.

[33:06] Context does matter. If you are someone who’s very stress sensitive, you’re probably going to want to learn to use carbohydrates to your advantage. Someone who’s very stress sensitive, cutting carbohydrates completely out may not be the best situation here. May, because there’s always individual variations here, but in my clinical experience, cutting out carbohydrates too fast, too extreme, is a problem, which is why I like to have those ratios of 30/40/30 and 40/30/30. They’re more moderate. The protein suppresses appetite, there’s enough carbohydrates, but not too much, there’s enough fat, but not too much. That’s the context part. Exercise is a big one there. You can kind of be thinking about with exercise, you want to do a few things: you may want to have carbohydrates prior to exercise, or after exercise, to both help with performance and to help with recovery. Again though, the carbohydrate tipping point – we don’t want too much but we want enough; so, how would you know? You would know if I have a little bit of a banana 30 minutes before my workout, I have a great workout, then that’s probably a good thing for you to do; or like the opposite of that, I don’t have any carbohydrates, I do my workout, and I’m dragging like crazy; or the opposite side of that, or the end of that, after your workout, you don’t have carbohydrates, as a result of that, you’re ravenous all day for the rest of the day, and/or you remain sore for long periods of time vs. when you have carbohydrates you don’t have that excess hunger, you also are not as sore and have recovered better from your workouts. And remember, if you’re someone who’s trying to maintain your lean body mass, or more importantly, even gain lean muscle, carbohydrates become critical. If I asked you a question and said, what is the most anabolic hormone in the body, most people would say testosterone or human growth hormone. What I would say is insulin, and the reason I’d say insulin is because you can’t get the fuel the body needs, the cells need, in without insulin. Insulin, to me, is, by far, the most anabolic hormone in the body. If you’re trying to get a athletic physique, then that means you want to maintain or even gain muscle, which means some muscle, or some muscle building potential is going to be needed. That means carbohydrates may be the solution there, which is why I give a 40/30/30 ratio – 40% carbohydrates for people who are training like crazy, wanting to burn fat, but still being able to maintain or gain muscle. Now, of course, protein also releases insulin, so if you’re not going to do carbs, you may want to make sure you’re ramping up protein a little bit more on your low carb, ketogenic type diets.

[36:02] So, maybe it’s going to be 5/25/70 in terms of a keto diet. Now, in some people who aren’t exercising, that might not get them into ketosis, but for those who do exercise, that higher level of protein can still keep them in ketosis. So, if you don’t like the carbs, you don’t do well on them, then you certainly can look at the situation where you’re going to be using protein in lieu of carbs. That covers the amount and the context. Let’s cover the type of carbohydrates. Now, from my perspective, people lump all carbohydrates together as they’re bad. Don’t forget, vegetables are carbohydrates, fruit are carbohydrates, and vegetables and fruit have something that other starchy carbohydrates don’t; and what they have is a lot of water and higher percent of fiber vs. starch. If you look at the total amount of fiber in vegetables and fruits, it doesn’t have a total amount. You’ll find higher amounts in grains, totally speaking. However, if you look at the amount of fiber relative to starch, it’s very favorable, and these things also come along with a lot of water. That’s one of the reasons fruits and vegetables are the primary ways you want to be getting your carbohydrates in, because they’re highly satiating, they bring fiber and water, which both of those together are satiating. Now, once you start getting into the starches, you want to be thinking about something that you probably haven’t heard before, but I’ll make this distinction for you – wet, bland starch vs. dry, tasty starch. Now, here’s why. Many of you may not know, but there’s only one study really done on this – there’s something called the satiety index, this needs to be repeated – but researchers went and looked at all the different foods and measure their satiety on average in different people, and what they found was that the number one satiety food was the potato, and the potato is very hunger suppressing. Now, you have to be careful with a potato because it’s a palate for what? It’s a palate for salt and it’s a palate for fat, so the potato becomes the standard, Western way of eating, which is this, you know, fat bomb, starch bomb, and salt bomb all in one. However, if you have just a plain potato, it is blander, it is very packed with water, and it has some starch to be satiating to release some insulin, and it’s basically released a little bit more in a context, in a way that helps satiate the body. So, wet, bland starch is not typically overeaten. Think about rice and Asians. Go tell an Asian culture that rice makes you fat. The difference between the way the Asians eat their rice though and Americans eat their rice is that Asians eat plain, wet rice. Wet, bland rice. In America, we eat salt-laden, fat-laden rice. Those two things are very different.

[39:01] When you’re thinking about the starches, first you want to go fiber and water, so fruits and vegetables. But then, once you get into the starches, you want to be thinking wet, bland starch. A plain baked potato, plain rice, those kinds of things. You want to avoid things that are dry and tasty. What do I mean by that? Well, think about a French fry, or better, a potato chip. These things are dry, they’re crunchy, they’re extremely tasty; again, they’re fat and salt-laden plus they’re more dry. Think about a cracker, same thing. Think about bread, sort of same thing, right? Bread is salty. So, these things are tasty. They also have these textures like crunchy, and gooey, and chewy. You want to be aware of those things because they tend to make us overeat. The science now on palatability and hedonistic potential of foods is very clear that certain foods make us overeat more. If you want to, in my opinion, the number one thing we want to do is suppress hunger so we don’t overeat naturally. That means we want to stick with wet, bland starches that are very hunger suppressing, and not dry, tasty, gooey, chewy, crunchy types of starches. If you just made that one shift, you would have a huge difference. Yes, candies, yes, Coca-colas, yes, these kinds of things, but also staying away from dry, gooey, chewy, crunchy, tasty, salty type of starches, and stick with wet, bland, plain starch, as well as fruits and vegetables, and now that becomes the percent. Like, if you’re eating a 40% carbohydrate diet, that’s what you want, fruits and vegetables and wet, bland types of starches, not dry, tasty, gooey, chewy, crunchy starches. Now, the other thing that we need to talk about here when we talk about types of carbohydrates is, we need to talk about sugars. Sugars are very important to understand and, of course, table sugar, simple sugar, it also gets much maligned. It gets much maligned, but it is one of these things, especially when it’s combined with fat, that just makes everything taste freakin’ fantastic, so we have to be careful about sugar. When we talk about sugar, I’m really, again, talking about these dry, tasty, gooey, chewy, crunchy things. I’m talking about candy here too; I’m talking about pastries here too; I’m talking about cookies, I’m talking about cakes, I’m talking about all that kind of stuff; and I’m even talking about high amounts of fat with sugar. Like what? A doughnut, or cheesecake, or those kind of things. Those things have no place other than in very small amounts. Every once in a while on very special occasions those things. No one is going to become healthy by eating these dry, tasty, gooey, chewy, crunchy, sugary, salty types of things, so they become very, very low in your diet.

[42:01] If you’re going to eat those kinds of things, then you’re going to have to pay very close attention to calories, and they make it very, very difficult to do that; so, it’s best to – I wouldn’t say avoid, because as soon as you avoid, it’s kind of like this situation where you’re automatically priming your brain to want those things – but make your choices fruits and vegetables, wet, bland starches, avoid all that other stuff. Now, when it comes to sugars, we do need to have a conversation that comes to types, we do need to have a conversation about this idea of things like gluten and things like FODMAPs, and things like that. Here’s the thing, we now know that there is such a thing as non-celiac’s gluten sensitivity where people can react to gliadin and other proteins that are prevalent in grains. It’s not just gluten, but gluten is the most popular one. There are some people who need to avoid grains. Well, the goods new here is that when you avoid dry, tasty, gooey, chewy, crunchy types of carbohydrates, you’re automatically removing grains, in a sense, from that. So, gluten-free diets really should be even gone further and you should be talking about grain-free diets. This is why I brought up the wet, bland starches, which my favorite would be sweet potato, regular potato, and rice, or quinoa, and stuff like that. We kind of want to be a little bit more careful once we go into the grains. At the same token, beans are another one of these ones that they tend to be wet and bland, they also tend to be high in fiber and high in protein. They kind of are another great starch to have, so maybe we want to add beans to that. The problem though with beans gets us into this conversation about digestibility of things. This is where this term FODMAP comes from. That stands for fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols. So, just a brief lesson in the biochemistry of sugar really quick – there’s basically 3 monosaccharides. There’s glucose, there’s fructose, and there’s galactose. When I say monosaccharides, it’s a simple, noncomplex sugar. Now, those sugars can be combined to form disaccharides. Glucose and glucose can form maltose; glucose and galactose can make lactose; glucose and fructose make sucrose, table sugar. By the way, sucrose, table sugar, is 50% glucose and 50% fructose. You may have heard about high fructose corn syrup – well, high fructose corn syrup is about 55% fructose and the rest glucose, so it’s not that big of a difference. High fructose corn syrup isn’t that big of a difference from sucrose; however, there are some very higher fructose container sweeteners, like an example would be… the name’s slipping my mind right now, but what’s the cactus – agave – agave syrup can be up to 90% fructose.

[45:09] There’s certain sweeteners that can have more fructose in them. Now, fructose can be a problem because when we talk about fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols, the monosaccharide that most people are sensitive to is going to be fructose. Not everyone can handle fructose, and part of the reason for that is fructose is absorbed a little bit differently than glucose is. In fact, when fructose is absorbed it kind of hitches a ride with glucose. This is one of the reasons why you can tolerate a little bit more fructose when you eat it with glucose. It’s one of the reasons why maybe sucrose doesn’t cause people who are fructose sensitive that much issue. Table sugar, even though it’s 50% fructose because it has the glucose with it, but as soon as you start getting into high fructose corn syrup where it’s slightly more fructose, now the negative effects on the GI tract can be seen with fructose. This is why you want to, if you have sensitivities, this where issues with sodas and things like this, which are very high in fructose, they have high fructose corn syrup rather than sucrose. So, if you love sodas, then you probably want to go to one that’s – the old ones, the ones that have just sucrose. You might do a little bit better. Now, once you start combining these simple sugars, glucose, fructose, and galactose, you start making the disaccharides. So, lactose is the milk sugar that is a disaccharide. Many people can’t break that down; they have a lactase enzyme deficiency. So, different types of disaccharides can cause issues. Then, the real issues start going when you get oligosaccharides, which is basically several chain. It’s basically 3-10 of these monosaccharides in a chain make up an oligosaccharide, and more than 10, we typically call that a polysaccharide. Once you start getting these big long chains of sugar, some people, in their digestive tract, cannot break these down. Their enzymes can’t reach them and break them down, so it leaves food for the bacteria in the gut and can cause a lot of gas, bloating, diarrhea, and that kind of stuff. So, irritable bowel syndrome, in the last 5-10 years, there’s been a rash of research showing that irritable bowel syndrome, IBS, is not due to a food allergy or sensitivity, but mainly it’s a sensitivity to these FODMAPs, and a low FODMAP diet can help with irritable bowel syndrome. Now, the other thing we got to talk about with type is the idea of sugar alcohols, and this is getting long in this discussion now, and I know I’m going a mile a minute, but there are certain sugars, sweetener alternatives. I guess I’ll try to just go through a discussion of those really quick here, although hopefully it gives us time to get into the timing of this. I guess it’s ok if this goes a little bit long, but when we talk about type, we also talk about the idea that people love the taste of sweet, don’t they?

[48:05] So, in a sense, we need to look at alternative sweeteners. Now, there are synthetic alternative sweeteners. These would be things like Splenda, and Equal, and NutraSweet, and Sweet’N Low, and things like that, and then we also now have a ton of good options in the natural world for sweeteners. Let me just go through sort of the synthetic sweeteners really quickly, and this where I may get in trouble with those of you who are purists. Those of you who listen to me a lot, by now you should know that I am an unbiased person. I want truth, and I just want the data to tell me. I don’t care that it’s synthetic vs. nonsynthetic. If I have a bias, I am biased towards natural things. So, I do have a slight bias, but I also – I don’t want to let my natural medicine bias go so far that ignore things that can work in the not natural world. There are plenty of things that are not natural that can be helpful, and there are plenty of things that are natural that can kill you, like belladonna. There’s plenty of plants that, if you eat them, are going to make you sick and kill you. So, we need to kind of be careful about this. Now, the thing that you want to understand is that, in my mind, when we look at all these – let’s do the synthetic sweeteners first – let’s take on Sweet’N Low first. This is typically the sweet, the pink packet that you see at many restaurants. This contains – well, if you’re here in the United States where I am, Sweet’N Low typically contains saccharin. If you’re in Canada, it typically is cyclamate. The story behind this is that it used to be saccharin and cyclamate Sweet’N Low, but then there was some, you know, rat research came out showing that there was a concern for bladder cancer when they gave rats very high amounts of this. The United States blamed it on cyclamate and took cyclamate out, so the Sweet’N Low company just gave us saccharin. And Canada blamed it on saccrahin, and so they ended up with cyclamate. Now, research since then has showed that that data was flawed, there’s probably no risk whatsoever with it, and so now you may start seeing Swet’N Low come back and be saccharin plus cyclamate; but that’s the story there. These Sweet’N Low, at this point, seems to be safe. As a matter of fact, if you look at – it’s really good when you see multiple countries, like the European Union, the Food and Drug Administration, the European drug administration, the Asian drug administration, when they all agree and line up, it’s a good sign – so when it comes to saccharin and cyclamate, most of them are lining up now. Same thing, by the way, with aspartame and acesulfame. I know aspartame gets a really bad rap – this is the one that’s in NutraSweet, and Equal, and Canderel that you’ll find in Europe and places – and this a methyl ester of the amino acid phenylalanine, so many people say that it is an amino acid.

[51:11] It is made from the amino acid. Now, it often times comes combined with acesulfame, and the reason why is because aspartame and acesulfame, one of them – they both kind of have… they can kind of have off flavors, a little bit more metallic taste – but when you combine them the taste is a little bit better. Again, this one is probably – it is, not probably – it is the most studied sweetener on the planet, aspartame. It has been studied up and down, every which way, and every single body agrees that in amounts typically consumed, not the amounts they feed, like truckloads full equivalents to rats, that it is safe, that it is safe and usable. Now, I don’t know about you, but I’m more natural medicine bias – I try to avoid these things. I don’t necessarily trust them, but I certainly am not scared of them, and certainly am not going to go around saying they cause cancer and things like that when the research just isn’t there. That may be the case one day, but right now, we have lots and lots and lots and lots of research on this, and the vast majority of research says no. Now, you could find one study out of 10,000 that basically says this causes and issue, and people who are so biased against these things will pull up that one study; so, you do have to look at this in its totality. To me, saccharin, Sweet’N Low, and cyclamate, aspartame, acesulfame, Equal, those kind of things, the one that I do have the most concern about is sucralose. It’s been around – this would Splenda – it’s been around not as long and it has many issues. Basically, what has happened is several different organizing bodies, especially, I think, the Committee for Responsible Medicine, or something like that, they basically have downgraded it based on a 2014 study and a 2016 from safe to avoid, safe to caution to avoid, and they recommend that you’re avoiding it now. From my perspective, based on that, based on what we don’t know about this, I would say it’s probably the worst of these. Now, the big issue here, one of the big issues here is all of these are 200-300 times – in the case of sucralose, a 1,000 times – sweeter than sugar. What this does to our tongue is something called the neurolingual response, or the cephalic phase insulin response. All this means is that when the tongue tastes sweet it’s expecting sweet, and it often times in some people, not all, will release insulin. If no sugar comes, that insulin can lower blood sugar, which then sets off alarms to the body that says oh my god, we have low blood sugar, let’s raise blood sugar, and also can increase hunger. So, there are some issues with these synthetic sweeteners because they’re so sweet. Then, on the natural side, stevia is also 200 times – 300 times sweeter than regular sugar.

[54:11] It can have some of the same issues in people with cephalic phase insulin response. However, stevia’s been around longer, people have been using it for a very long time, it’s relatively safe. In fact, it has some antiviral activities. By the way, stevia is often times seen as reb A or stevioside on labels, but that is derived from – and what they’re doing, by the way, is they’re taking the plant that’s the stevia plant and basically removing the active compounds, rebaudiana A and stevioside, certain steviosides, to use as a sweetener. So, stevia is a really good alternative, and you don’t need a whole of it, but it does have an after taste that a lot of people don’t like. The next one would be monk fruit, luo han. Many people have seen this particular herb. It’s often times known as – can I remember the name here… it’s siraitia grosvenorii I think, something like that. If you see grosvernorii on there, that’s that plant. It’s normally though described as luo han or monk fruit. Now, stevia has zero calories. Luo han, monk fruit, has zero calories as well, and the active compound in that is also – it may show up on labels as mogroside. The mogrosides are the chemical compounds in the luo han, or the monk fruit, that actually – and egroside. Egroside, I think – mongroside and egroside – these are the chemical compounds that are sweet in monk fruit, and these things can be useful. Then, as we get into the alcohols, these are my favorites – xylitol, erythritol, maltitol, sorbitol, and a new one of the market called allulose. Maltitol and sorbitol, these are about 60% as sweet as sugar. These two are not well absorbed though, so go back to the FODMAP discussion – fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols – well, the polyols, maltitol, sorbitol, these things can wreak havoc on the digestive system because they’re not well absorbed, so they pull in a lot of water and cause diarrhea. Part of the reason they’re not well absorbed though is part of their satiety profile. They don’t get absorbed in the body whereas erythritol actually does, but erythritol, which is 70% as sweet as sugar – this one’s my favorite – it does get absorbed, it’s very gentle on the GI tract because of that, but then it’s unmetabolized and almost entirely excreted in the urine. Allulose, or D-psicose – that’s psicose with a P, P-S-I-C-O-S-E – also is very similar to erythritol.

[57:03] These are 70% as sugar, and they don’t have the after taste that maltitol and sorbitol and xylitol have. These are probably one of the best and they have lower calories than those other ones. So, those other ones have – there’s 4 calories per gram of sugar – so xylitol has about half of that, so does sorbitol and maltitol, but erythritol and allulose have negligible amounts. They have like about .2 calories per gram of them, so they’re essentially zero calorie. So, of the natural sweeteners, the ones I like the best are erythritol and allulose for baking and stuff like that because they can be used 1 per 1 in terms of sugar, and then stevia and monk fruit. Xylitol is interesting, because xylitol is a very healthy compound. We make it in our body every day. It is somewhat hard on some people’s digestive tracts, but you can get used to it and it’s not nearly as maltitol and sorbitol. Xylitol has a slightly cooling flavor so it’s often times used in mints and things like that, but it also has really good benefits for the upper respiratory tract, which is interesting now when we’re talking about a virus. Right now, if you’re listening to this episode later on, we’re right in the middle of the coronavirus quarantine. I use a xylitol spray every day because it is a natural humectant, which pulls water – humectant is a compound that pulls water into itself, so it can hydrate the mucous membranes – and xylitol’s also bacteria-static, so it decreases the risk of certain bacteria; it’s also microbial static. There is some indication, perhaps. This is somewhat theoretical now, so it may or may not be true, but it also may have some blocking action with viruses. We know it’s definitely bacterial-static, which means – it’s not bactericidal where it kills bacteria, but it keeps bacteria from adhering to the mucous membranes, and it may do the same with viruses. That is the discussion on type – I wasn’t really planning on going into all the sugar types, but hopefully that’s useful to you. And the final thing here and then I’ll end this is the timing. The timing issue is really important here, and this has to do with frequency as well, like how many meals are you going to have carbohydrates at. One of the things that when you look at carbohydrates, that I like to do is - one of the reasons it’s one of my favorite macronutrients is because what you can do with carbohydrates is you can use that insulin surge to shut down hunger, to program circadian clocks a little bit, and to recover from exercise. So, I like to use carbohydrates in that way. Now, if we just look at the circadian clock, often times, if you look at blood sugars in the morning, some people oversecrete stress hormones, so when they’re fasting they oversecrete their stress hormones.

[01:00:10] This is really interesting too, because it’s one of the only times you’re more insulin sensitive in the morning, but you also have high cortisol, which typically isn’t the case. The only time that’s the case is with exercise, where you have high cortisol and more insulin sensitivity. So, first thing in the morning after a fast, assuming you fasted for at least 12 hours, you have this high cortisol, high adrenaline state along with this insulin sensitized state. This is a really good time, perhaps, to eat a little bit more carbohydrate… for several reasons. You have the ability to burn it all throughout the day, you’ve got glycogen depletion throughout the night, and there is some indication it might cause you to be less hungry in the evening. This would be this situation where we’re essentially front loading carbohydrates, eating the allotment of carbohydrates first thing in the morning, which if you’re someone who loves breakfast foods and things like that, this could make sense for you, couldn’t it? Breakfast cereal, something like that, and then you don’t have any other carbohydrates for the rest of the day. At the same token, you can backload your carbohydrates as well and eat most of them at the last meal. This is helpful because carbohydrates can increase serotonin production, relaxing the brain, they can – if you tend to be one of these people that has high stress hormone secretion at night – these carbohydrates can help bring that down. Remember, there’s this relationship between hey body, don’t give me all these stress hormones, I’ll give you the sugar that you’re trying to get; so, people who have difficulty sleeping because they’re wired at night may benefit from moving all their carbohydrates to the end of the day. Of course, if you’re a performance person and you’re getting ready to run a marathon or something like that, having your carbohydrates prior to that particular activity can be useful. However, don’t make the mistake that a lot of people make – if you’re trying to load up your glycogen stores, you can’t really do it in the hours before exercise, you kind of have to do it the night before. If you’re going to run a marathon, you kind of maybe want to load up carbs the night before, or if you’re going to have a super intense workout later in the afternoon, you want to load up on carbs in the morning. That’s especially if you’re trying to load up on glycogen. However, if you’re just wanting some quick energy to get through a high intensity, short duration workout, a small amount of simple carbohydrates from fruit, or honey, or some of these Gu’s ,and things like that can be taken pretty close to workouts and have some benefit. So, this is the considerations; carbohydrates are very versatile. Then, of course, if you’re trying to gain muscle, having carbohydrate post-workout, immediately post-workout, with some protein to get that insulin surge in what we call that anabolic window, that could be beneficial as well.

[01:03:01] So, in a sense, we can use these pre-workout for performance enhancement, post-workout for increased recovery, front loading the day to deal with this issue where are going to use this energy throughout the day, and we are going to suppress an overactive adrenal response in the morning, and take advantage of this insulin sensitive time, or backload them, have them only at night, or mostly at night to take advantage of the serotonin production, the suppression of some of the adrenaline and cortisol, and things like that, and some people who have low drops in glucose at night. These are all the considerations here with carbohydrates, and now I’m sitting here thinking, did I cover everything? I went on and on and on for a while, not sure how long this episode’s going to be. But I think I pretty much covered everything. Just to review a couple key points here – one, think about carbohydrates and calories, they’re somewhat linked. A low calorie diet is almost always, not always, but almost always a low carb diet. At the same time, a low carbohydrate diet, with everything else being equal, is also a low calorie diet. So, this is part of the issue that we get into here. When you’re thinking about carbs you want to be looking at them from this ACTT acronym. The amount of carbs you eat - this includes total amount in terms of calories, but also percentages. I typically like the 30/40/30 for those who aren’t that active and the 40/30/30 for those who are very active. Then, we talked about this idea that there might be some benefit in having an extreme – either a very high carb diet, just don’t have fat with it, or a very high fat diet, just don’t have carb with it – and the idea that the fat/carb combination might be more of the issue. Then, we talked about this idea of context. More stress, more exercise, more training, you really kind of want a little bit more carb for most people. But just remember, we want the bell-shaped curve – not too much, not too little, but just right – that carbohydrate tipping point. Type, we talked about we want fiber, water-based carbs that are wet and bland, avoid the dry, tasty, gooey, chewy, crunchy type stuff. If you have issues with FODMAPs – fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols – or gluten, you want to avoid those things. We went through a bunch of sweeteners, so you can just review that information. And then think about timing. Use your carbohydrates smartly based on what you need. A carbohydrate can be one of these things that really helps the circadian rhythms and is most beneficial in that context, having most of them in the morning and avoiding them at night. But you also can – that would be frontloading your carbs. Backloading your carbs may though help some people sleep. Then, of course, we have this pre-workout for performance and this post-workout for recovery situation. I hope that’s useful for you for carbohydrates. I think I covered everything that I can think of, and I will see you at the next podcast. And just do me a favor – send me a message, DM me on social media, leave me a review, let me know how you liked this particular episode. The reviews are very, very helpful. I appreciate you all. Thank you so much. I will see you at the next episode.